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NPI Code Detail

MEDICARE: STEPHEN J TALTY M.D.

MEDICARE: STEPHEN J TALTY M.D.
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
1208100000XPhysical Medicine & Rehabilitation Physician036080186IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3250003386OTHERILMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101618781OTHERILBC/BS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306821053
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN J TALTY M.D.
Provider Business Mailing Address
First Line : 909 E PALATINE RD
Second Line :
City : PALATINE
State : IL
Zip : 60074-5551
Country : US
Telephone Number : 847-776-1400
Fax Number : 847-776-1424
Provider Business Practice Location Address
First Line : 909 E PALATINE RD
Second Line :
City : PALATINE
State : IL
Zip : 60074-5551
Country : US
Telephone Number : 847-776-1400
Fax Number : 847-776-1424
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 10/13/2020

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Directions to “ STEPHEN J TALTY M.D.” Practice Location

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