Individual provider Active NPI

Estelle Shirley Fletcher, MD, PHD

  • Family Medicine Physician
  • Joliet, IL
National Provider Identifier
1659320133
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-089471 Issued in IL
Practice address
99- 129TH Infantry Drive
Joliet, IL 60435-5134
Phone
(815) 744-3335
Fax
(815) 744-3701
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-089471 IL Primary

Addresses

Primary practice location

99- 129TH Infantry Drive
Joliet, IL 60435-5134

Mailing address

99- 129TH Infantry Drive
Joliet, IL 60435-5134
Phone (815) 744-3335

Other identifiers 1

IdentifierTypeStateIssuer
036-089471MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080312000123 IL Practitioner - Family Practice 7416032677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

99 N 129TH Infantry Dr
Joliet, IL 60435-5134
Phone (815) 744-3335

Hospital & facility affiliations

  • Saint Joseph Medical Center Hospital, Joliet, IL, CCN 140007
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
036-089471ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Estelle Fletcher MD PHD Family Doctor S.C. Family Medicine CurrentSince May 1, 2002 Accepting new patients

Locations

99 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 744-3335

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1659320133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99- 129TH INFANTRY DRIVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355134",
            "telephone_number": "815-744-3335",
            "fax_number": "815-744-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99- 129TH INFANTRY DRIVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355134",
            "telephone_number": "815-744-3335",
            "fax_number": "815-744-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "ESTELLE",
        "middle_name": "SHIRLEY",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-089471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-089471",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.