Healthcare Provider Details

I. General information

NPI: 1841200409
Provider Name (Legal Business Name): STEPHEN LITTLETON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WINFIELD ROAD
WINFIELD IL
60190
US

IV. Provider business mailing address

25 WINFIELD ROAD
WINFIELD IL
60190
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-4700
  • Fax: 630-933-4721
Mailing address:
  • Phone: 630-933-4700
  • Fax: 630-933-4721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036-110236
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number036110236
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036110236
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036-110236
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: