Healthcare Provider Details

I. General information

NPI: 1871862888
Provider Name (Legal Business Name): STEPHANIE L MCCABE APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SAINT CLARE CT STE 100
WASHINGTON IL
61571-9239
US

IV. Provider business mailing address

10 SAINT CLARE CT STE 100
WASHINGTON IL
61571-9239
US

V. Phone/Fax

Practice location:
  • Phone: 309-886-4000
  • Fax: 309-886-4101
Mailing address:
  • Phone: 309-886-4000
  • Fax: 309-886-4101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209020054
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number209.009304
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277004258
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: