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Michael Patrick Stover

Surgery

Allopathic & Osteopathic Physicians

600 S Paulina St Ste 403, Chicago, IL 60612-3806

PECOS Enrollment

This provider is enrolled in PECOS as MICHAEL STOVER.

Based on the most recent information from CMS, provider Michael Patrick Stover is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1518701648
Provider Type
Individual
Full Name
Stover, Michael Patrick
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/24/2024
Last Updated
6/24/2024

Contact Information

Practice Location

600 S Paulina St Ste 403, Chicago, IL 60612-3806

(312) 942-7100

Unlisted Fax

Mailing Location

600 S Paulina St Ste 403, Chicago, IL 60612-3806

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208600000X Primary	Description Surgery Allopathic & Osteopathic Physicians	License 125084056 Illinois

Michael Patrick Stover

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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