MEDICARE: STEPHEN WHITMORE MD

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	207R00000X	Internal Medicine Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01622869	OTHER	IL	BCBS PROVIDER ID

General Provider Information

NPI Number	:	1699761551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN WHITMORE MD

Provider Business Mailing Address
First Line	:	777 OAKMONT LN
Second Line	:	SUITE 1600
City	:	WESTMONT
State	:	IL
Zip	:	60559-5511
Country	:	US
Telephone Number	:	630-789-2550
Fax Number	:

Provider Business Practice Location Address
First Line	:	7261 S EXCHANGE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-2533
Country	:	US
Telephone Number	:	773-768-6288
Fax Number	:

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	02/28/2008

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Directions to “ STEPHEN WHITMORE MD” Practice Location

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