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Organization
STEPHENSON GUT VITALITY & HEALTH PLLC
Active
Organization
STEPHENSON GUT VITALITY & HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY STEPHENSON FNP-BC (APRN)
(217) 778-2188
Entity
Organization
Contact information
Practice address
64 E CHESTER ST STE 106, CHAMPAIGN, IL 61820-4116
(217) 778-2188
(888) 252-7228
Mailing address
PO BOX 43, MAHOMET, IL 61853-0043
(217) 778-2188
(888) 252-7228
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
171400000X
Health & Wellness Coach
—
—
202D00000X
Integrative Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/26/2026
Last updated
05/03/2026
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