Stephanie Calderas, RN
Individual provider Active NPI Family Nurse Practitioner · Washington, IL
NPI 1649867003 · NPPES record last updated Aug 2, 2023
Key facts
- NPI
- 1649867003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209022226 (IL)
- Practice address
- 803 S Elm St
Washington, IL 61571-2607 - Phone
- (309) 360-9801
- NPI assigned
- Dec 30, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Applebaum Physiatry PLLC
Ameriwound Physicians Il LLC
Practice addresses (Care Compare)
2081 N Main St
Canton, IL 61520-1032
Phone (309) 647-6135
901 Illini Dr
East Peoria, IL 61611-1840
Phone (309) 694-6446
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230425002385 | IL | Practitioner - Nurse Practitioner | 4082079124 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041394519 | IL | MD | Neonatal Intensive Care Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellbe Senior Medical Illinois PC | Current |
Accepting new patients | |
| Traditions Hospice of Winfield, LLC | Current |
Accepting new patients | |
| Applebaum Physiatry PLLC | Family | Current |
Accepting new patients |
| Midwest Post Acute Care PLLC | Current |
Accepting new patients | |
| Ameriwound Physicians Il LLC | Current |
Accepting new patients |
Locations
2081 N Main St
Canton, IL 61520
Phone (309) 647-6135
129 S 1st Ave
Canton, IL 61520
Phone (309) 647-4327
1675 E Ash St
Canton, IL 61520
Phone (309) 647-2012
5061 N Pulaski Rd
Chicago, IL 60630
Phone (773) 478-1186
225 W Washington St
Ste 1700
Chicago, IL 60606
Phone (234) 200-4220
901 Illini Dr
East Peoria, IL 61611
Phone (309) 694-6446
275 E Carl Sandburg Dr
Galesburg, IL 61401
Phone (309) 344-1121
1650 Old Indian Town Rd
Henry, IL 61537
Phone (309) 364-3905
401 9th St
Lacon, IL 61540
Phone (309) 246-2175
550 Warrenville Rd
Ste 200
Lisle, IL 60532
Phone (312) 776-2422
4957 Oakton St
Skokie, IL 60077
Phone (773) 308-8934
1N131 County Farm Rd
Winfield, IL 60190
Phone (630) 682-3871
128 S East St
Unit 1109
Crown Point, IN 46308
6150 Parkland Blvd
Ste 225
Mayfield Hts, OH 44124
Interoperability endpoints
- stephanie.calderas.p1@direct.thmg.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Intensive Care Registered Nurse | 163WN0002X | 041394519 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209022226 | IL | Yes |
Addresses
Primary practice location
803 S Elm St
Washington, IL 61571-2607
Mailing address
803 S Elm St
Washington, IL 61571-2607
Phone (309) 360-9801
Other names
- Stephanie King
Other providers in Washington, IL
- Cheryl Lynn Bunyan
- Dennis C Burton
- Kara Bushong
- Lisa House/Apartment Byard
- Jon Byler
- Scott Carlson
- Chelse Carr
- Kelsey James Carreras-Simons
- Central Columbia Grade SCH 51
- Central Illinois Senior Care, Inc.
All providers in Washington, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.