Individual provider Active NPI

Stephanie Ann Heraty, MD

  • Obstetrics & Gynecology Physician
  • Evanston, IL
National Provider Identifier
1972767895
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036.119864 Issued in IL
Practice address
1000 Central St Ste 700
Evanston, IL 60201-1769
Phone
(847) 869-3300
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036.119864 IL Primary

Addresses

Primary practice location

1000 Central St Ste 700
Evanston, IL 60201-1769

Mailing address

2801 Lakeside Dr Ste 209
Bannockburn, IL 60015-1271
Phone (847) 562-1410

Other practice location 1

3000 N Halsted St
Suite 309
Chicago, IL 60657-5188
Phone (773) 296-3300

Other names 1

  • Stephanie Heraty Professional name

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
I20090827000530 IL Practitioner - Obstetrics/Gynecology 6608920533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Indiana University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Center for Women'S Healthcare, LTDGroup PAC ID 7012818354, 93 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700
Phone (847) 562-1410

350 S Northwest Hwy
Park Ridge, IL 60068-4262
Phone (847) 825-8108

3633 W Lake Ave
Suite 204
Glenview, IL 60026-5802
Phone (847) 729-2108

4709 Golf Rd
Suite 320 325
Skokie, IL 60076-1231
Phone (847) 499-2648

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.119864ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jan 1, 2014 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 1, 2014 Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

3000 N Halsted St
Ste 309
Chicago, IL 60657
Phone (773) 296-3300

75 Remittance Dr
Chicago, IL 60675

29373 Network Pl
Chicago, IL 60673

350 S Northwest Hwy
Ste 112
Park Ridge, IL 60068
Phone (847) 825-8108

Interoperability endpoints

  • Direct secure messaging: stephanie.heraty.1@21117.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1972767895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 LAKESIDE DR STE 209",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151271",
            "telephone_number": "847-562-1410",
            "fax_number": "847-562-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CENTRAL ST STE 700",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011769",
            "telephone_number": "847-869-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 N Halsted St",
            "address_2": "Suite 309",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575188",
            "country_code": "US",
            "telephone_number": "773-296-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERATY",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.119864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HERATY",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.