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John H Stewart

Surgery

Allopathic & Osteopathic Physicians

1801 W Taylor St, Occ-3f, Chicago, IL 60612

PECOS Enrollment

This provider is enrolled in PECOS as JOHN STEWART.

Based on the most recent information from CMS, provider John H Stewart 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
1851374383
Provider Type
Individual
Full Name
Stewart, John H
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
11/29/2005
Last Updated
7/8/2020

Contact Information

Practice Location

1801 W Taylor St, Occ-3f, Chicago, IL 60612

(312) 355-4300

Unlisted Fax

Mailing Location

840 S Wood St, Mc 958, Chicago, IL 60612

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208600000X Primary	Description Surgery Allopathic & Osteopathic Physicians	License 036-147175 Illinois
Code 2086X0206X	Description Surgery Allopathic & Osteopathic Physicians	License 036147175 Illinois
Code 2086X0206X	Description Surgery Allopathic & Osteopathic Physicians	License 200401335 North Carolina

Provider Identifiers

ID	Description	Issuer
ID Q01335	Description Medicaid	Issuer Unlisted South Carolina
ID 7073680	Description Other	Issuer AETNA
ID 89137Y9	Description Medicaid	Issuer Unlisted North Carolina
ID 3810001643	Description Medicaid	Issuer Unlisted West Virginia
ID D7081	Description Other	Issuer MEDCOST
ID P00253280	Description Other	Issuer RR MEDICARE
ID 036147175	Description Medicaid	Issuer Unlisted Illinois
ID 10139899	Description Medicaid	Issuer Unlisted Virginia
ID 137Y9	Description Other	Issuer BCBS
ID 804840	Description Other	Issuer PARTNERS

John H Stewart

PECOS Enrollment

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