MEDICARE: ADRIENNE STICH 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	208M00000X	Hospitalist Physician	036142629	IL
2	207R00000X	Internal Medicine Physician	036142629	IL

General Provider Information

NPI Number	:	1558776807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE STICH MD

Provider Business Mailing Address
First Line	:	PO BOX 19248
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62794-9248
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 N 1ST ST
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62702-3757
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:	217-606-3057

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

Provider Enumeration Date	:	06/25/2014
Last Update Date	:	04/07/2026

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Directions to “ ADRIENNE STICH MD” Practice Location

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