Active NPI
Stephanie Summers
- Driver
- Calumet City, IL
National Provider Identifier
1972779361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- S56278166683
- Practice address
- 1594 Kenilworth Dr
Calumet City, IL 60409-6306 - Phone
- (773) 425-8243
- Fax
- (773) 667-9622
- NPI assigned
- May 5, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | S56278166683 | IL | Primary |
Addresses
Primary practice location
1594 Kenilworth Dr
Calumet City, IL 60409-6306
Mailing address
1594 Kenilworth Dr
Calumet City, IL 60409-6306
Phone (773) 425-8243
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 343729196040901 | Medicaid | IL |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S56278166683 | IL | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209945600000",
"number": "1972779361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1594 KENILWORTH DR",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604096306",
"telephone_number": "773-425-8243",
"fax_number": "773-667-9622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1594 KENILWORTH DR",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604096306",
"telephone_number": "773-425-8243",
"fax_number": "773-667-9622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERS",
"first_name": "STEPHANIE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-05",
"last_updated": "2008-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "IL",
"license": "S56278166683",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "343729196040901",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Calumet City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.