Individual provider Active NPI

Albert Henry Stipes, M.D.

  • Forensic Psychiatry Physician
  • Woodstock, IL
National Provider Identifier
1861709719
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
036042922 Issued in IL
Practice address
210 Swarthmore CT
Woodstock, IL 60098-7879
Phone
(815) 206-0496
Fax
(815) 206-0431
NPI assigned
Sep 13, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 036042922 IL Primary
Psychiatry Physician 2084P0800X 036042922 IL

Addresses

Primary practice location

210 Swarthmore CT
Woodstock, IL 60098-7879

Mailing address

210 Swarthmore CT
Woodstock, IL 60098-7879
Phone (815) 206-0496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036042922ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1861709719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SWARTHMORE CT",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987879",
            "telephone_number": "815-206-0496",
            "fax_number": "815-206-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SWARTHMORE CT",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987879",
            "telephone_number": "815-206-0496",
            "fax_number": "815-206-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIPES",
        "first_name": "ALBERT",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "IL",
            "license": "036042922",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036042922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.