Stephanie Maceachern

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

125.078893 Issued in IL

Practice address

1675 Dempster St
Park Ridge, IL 60068-1110

Phone

(847) 318-9300

NPI assigned

Mar 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: smaceachern290362@direct.luriechildrens.org
• Direct secure messaging: smaceachern307288@direct.myadvocateaurora.org

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.

• Ann & Robert H. Lurie Children's Hospital of Chicago

  • Children's Hospital
  • Chicago, IL
  • NPI 1235234535
  NPD
• Pediatrust, L.L.C.

  • Pediatrics Physician
  • Lake Forest, IL
  • NPI 1982958013
  NPD (past)

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1952988420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681110",
            "telephone_number": "847-318-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEACHERN",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.078893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Lytle
• Vadim Lyuksemburg, M.D.
• Maaxora Med LLC
• Mab & Associates
• Andrew Charles Macdougall, D.O.
• Samantha Brooke Mackay-Forton
• Bridget Claire Mackey, DPT, PT
• Jason Nathaniel Macklis, M.D.
• Syeda Wajaha Madani, D.O
• Nikolina Ana Madjer, MD

• Pediatrics Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.