MEDICARE: RICK W STEPHANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician		IL

General Provider Information

NPI Number	:	1356399737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICK W STEPHANI MD

Provider Business Mailing Address
First Line	:	PO BOX 87904
Second Line	:	MEA ELK GROVE LLC DEPT 2049
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-7904
Country	:	US
Telephone Number	:	630-734-0200
Fax Number	:	630-734-1560

Provider Business Practice Location Address
First Line	:	800 BIESTERFIELD RD
Second Line	:	ALEXIAN BROTHERS MEDICAL CENTER
City	:	ELK GROVE VLG
State	:	IL
Zip	:	60007-3311
Country	:	US
Telephone Number	:	847-437-5500
Fax Number	:	630-734-1560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	07/08/2007

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