MEDICARE: MADISON ELAINE STEWART DC

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	111N00000X	Chiropractor	038.14142	IL

General Provider Information

NPI Number	:	1366201287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON ELAINE STEWART DC

Provider Business Mailing Address
First Line	:	6135 N KNOLL AIRE DR
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61614-3420
Country	:	US
Telephone Number	:	309-299-4192
Fax Number	:

Provider Business Practice Location Address
First Line	:	387 OLD GERMANTOWN RD
Second Line	:
City	:	GERMANTOWN HILLS
State	:	IL
Zip	:	61548-8679
Country	:	US
Telephone Number	:	309-383-2772
Fax Number	:	309-383-2773

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

Provider Enumeration Date	:	03/14/2024
Last Update Date	:	03/14/2024

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Directions to “ MADISON ELAINE STEWART DC” Practice Location

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