MEDICARE: STEPHANIE SIMMONS 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
1	207V00000X	Obstetrics & Gynecology Physician	036-104639	IL

General Provider Information

NPI Number	:	1346236585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SIMMONS M.D.

Provider Business Mailing Address
First Line	:	2040 OGDEN AVE STE 201
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-7205
Country	:	US
Telephone Number	:	630-978-6886
Fax Number	:	630-978-6806

Provider Business Practice Location Address
First Line	:	2040 OGDEN AVE
Second Line	:	SUITE 201
City	:	AURORA
State	:	IL
Zip	:	60504-7222
Country	:	US
Telephone Number	:	630-978-6886
Fax Number	:	630-978-6806

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	07/21/2020

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Directions to “ STEPHANIE SIMMONS M.D.” Practice Location

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