MEDICARE: EVERT M VANDERSTOEP,MD LTD

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	2084P0800X	Psychiatry Physician		IL

General Provider Information

NPI Number	:	1407903024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERT M VANDERSTOEP,MD LTD

Provider Business Mailing Address
First Line	:	151 N MICHIGAN AVE
Second Line	:	STE 814
City	:	CHICAGO
State	:	IL
Zip	:	60601-7506
Country	:	US
Telephone Number	:	312-856-0070
Fax Number	:	312-856-0070

Provider Business Practice Location Address
First Line	:	151 N MICHIGAN AVE
Second Line	:	STE 814
City	:	CHICAGO
State	:	IL
Zip	:	60601-7506
Country	:	US
Telephone Number	:	312-856-0070
Fax Number	:	312-856-0070

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EVERT M VANDERSTOEP
Credential	:	M.D.
Telephone Number	:	312-856-0070

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	08/22/2020

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