MEDICARE: STEPPIN STONE INC

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	276400000X	Substance Use Disorder Rehabilitation Hospital Unit
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1982212205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPPIN STONE INC

Provider Business Mailing Address
First Line	:	7244 W BENTON DR
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-9303
Country	:	US
Telephone Number	:	708-567-5053
Fax Number	:	815-464-9983

Provider Business Practice Location Address
First Line	:	7244 W BENTON DR
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-9303
Country	:	US
Telephone Number	:	708-567-5053
Fax Number	:	815-464-9983

Authorized Official
Title or Position	:	VP OF OPEATIONS
Name	:	DR. ANN ASSAM
Credential	:	PHARMD
Telephone Number	:	708-567-2053

Provider Enumeration Date	:	07/22/2020
Last Update Date	:	07/22/2020

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Directions to “STEPPIN STONE INC ” Practice Location

Language	Start Address	Practice Location

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