Stephanie Lindstrom, MD
Individual provider Active NPI Family Medicine Physician · Metamora, IL
NPI 1811903073 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1811903073
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036102894 (IL)
- Practice address
- 901 W Walnut Street
Metamora, IL 61548 - Phone
- (309) 367-4144
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Proctor Health Systems
Carle Health Care Incorporated
Methodist Medical Center of Illinois
Practice addresses (Care Compare)
1120 E War Memorial Dr
Peoria, IL 61616-7757
Phone (309) 685-4411
3591 Griffin Ave
Pekin, IL 61554-6258
Phone (309) 353-6301
3915 Barring Trce
Peoria, IL 61615-2500
Phone (309) 689-3030
528 Edward St
Henry, IL 61537-1218
Phone (779) 323-8150
5401 N Knoxville Ave
Peoria, IL 61614-5021
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977
901 W Walnut St
Metamora, IL 61548-8637
Phone (309) 367-4144
Hospital & facility affiliations
- Carle Home Care
- Carle Health Methodist Hospital
- Carle Health Proctor Hospital
- Saint Francis Medical Center
- Carle Eureka Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 18 |
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100824001036 | IL | Practitioner - Family Practice | 1355465634 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036102894 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proctor Health Systems | Family Medicine | Current |
Accepting new patients |
| Carle Eureka Hospital | Current |
Accepting new patients | |
| Proctor Health Systems | Family Medicine | Current |
Accepting new patients |
| Carle Health Care Incorporated | Family Medicine | Current |
Accepting new patients |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Carle Health Care Incorporated | Past | Accepting new patients |
Locations
901 W Walnut St
Metamora, IL 61548
Phone (309) 367-4144
5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610
815 Main St
Ste A1
Peoria, IL 61602
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- slindstrommd388518@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036102894 | IL | Yes |
Addresses
Primary practice location
901 W Walnut Street
Metamora, IL 61548
Mailing address
5100 Reliable Pkwy
Chicago, IL 60686-0001
Phone (309) 672-4809
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 472306 | Other | IL | HEALTHLINK |
| IL01L9 | Other | IL | JOHN DEERE |
| 0361028943 | Medicaid | IL | |
| 071728 | Other | IL | HEALTH ALLIANCE |
| 080182079 | Other | IL | RAILROAD MEDICARE |
| 7215059 | Other | IL | BCBS PPO |
Other providers in Metamora, IL
- Timothy Wayne Kaufman
- Elizabeth Michelle Kerr-Glascock
- Kyle Andrew Krall
- Krallyoder PC
- Nancy Lee
- Brandon Michael Ludolph
- Thomas Oliver Martin
- Mended Hearts Stable
- Metamora CC SCH Dist 1
- Metamora Community Nursing Home
All providers in Metamora, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.