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NPI Code Detail

MEDICARE: DR. STEPHANE DOUCET M.D.

MEDICARE: DR. STEPHANE DOUCET 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
1390200000XStudent in an Organized Health Care Education/Training Program036130561IL

General Provider Information

NPI Number : 1326300815
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANE DOUCET M.D.
Provider Business Mailing Address
First Line : 355 E OHIO ST UNIT 4004
Second Line :
City : CHICAGO
State : IL
Zip : 60611-4511
Country : US
Telephone Number : 312-888-0343
Fax Number :
Provider Business Practice Location Address
First Line : 676 N SAINT CLAIR ST STE 850
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3124
Country : US
Telephone Number : 312-695-5378
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2012
Last Update Date : 06/18/2012

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Directions to “ DR. STEPHANE DOUCET M.D.” Practice Location

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