Individual provider Active NPI

Stephanie Lindstrom, MD

  • Family Medicine Physician
  • Metamora, IL
National Provider Identifier
1811903073
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036102894 Issued in IL
Practice address
901 W Walnut Street
Metamora, IL 61548
Phone
(309) 367-4144
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 036102894 IL Primary

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 6

IdentifierTypeStateIssuer
472306OtherILHEALTHLINK
7215059OtherILBCBS PPO
IL01L9OtherILJOHN DEERE
071728OtherILHEALTH ALLIANCE
080182079OtherILRAILROAD MEDICARE
0361028943MedicaidIL

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
I20100824001036 IL Practitioner - Family Practice 1355465634 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Carle Health Medical Group Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Carle Eureka Hospital CurrentSince Jan 27, 2026 Accepting new patients
Proctor Health Systems Family Medicine CurrentSince Mar 1, 2021 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) 202-3062

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: slindstrommd388518@carlehiedirect.net

Organizations & group practices 6

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

Hospital & facility affiliations 5

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811903073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "309-672-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W WALNUT STREET",
            "city": "METAMORA",
            "state": "IL",
            "postal_code": "61548",
            "telephone_number": "309-367-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSTROM",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036102894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "472306",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PPO",
            "identifier": "7215059",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL01L9",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "071728",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080182079",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361028943",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metamora, IL

Sources for this page

Verify at the official NPI Registry.