Individual provider Active NPI

Stephen Alan Lipschultz, MD

  • Internal Medicine Physician
  • Wilmette, IL
National Provider Identifier
1659480739
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-057892 Issued in IL
Practice address
1515 Sheridan Rd Ste 31a
Wilmette, IL 60091-1828
Phone
(847) 920-2200
Fax
(847) 920-2201
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-057892 IL Primary

Addresses

Primary practice location

1515 Sheridan Rd Ste 31a
Wilmette, IL 60091-1828

Mailing address

1515 Sheridan Rd Ste 31a
Wilmette, IL 60091-1828
Phone (847) 920-2200

Other practice location 1

2500 Ridge Ave
Suite 307
Evanston, IL 60201-2477
Phone (847) 869-6200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slipschultz2668@direct.northshore.org

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
I20051129000771 IL Practitioner - Internal Medicine 3375563877 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-057892ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine CurrentSince Mar 1, 2017 Accepting new patients
Endeavor Health Medical Group CurrentSince Mar 1, 2017 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2500 Ridge Ave
Ste 30
Evanston, IL 60201
Phone (847) 869-6200

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2500 Ridge Ave
Ste 308
Evanston, IL 60201
Phone (847) 869-6200

2500 Ridge Ave
Ste 307
Evanston, IL 60201
Phone (847) 869-6200

9977 Woods Dr
Fl 3
Skokie, IL 60077
Phone (847) 663-8410

1515 Sheridan Rd
Ste 31A
Wilmette, IL 60091
Phone (847) 920-2200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1659480739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 SHERIDAN RD STE 31A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911828",
            "telephone_number": "847-920-2200",
            "fax_number": "847-920-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SHERIDAN RD STE 31A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911828",
            "telephone_number": "847-920-2200",
            "fax_number": "847-920-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Ridge Ave",
            "address_2": "Suite 307",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602012477",
            "country_code": "US",
            "telephone_number": "847-869-6200",
            "fax_number": "847-869-8808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIPSCHULTZ",
        "first_name": "STEPHEN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-057892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slipschultz2668@direct.northshore.org",
            "affiliation": "N",
            "address_1": "1515 Sheridan Rd Ste 31A",
            "city": "Wilmette",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600911828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.