Individual
ELIZABETH A STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2900 FRANK SCOTT PKWY W, SUITE 904, BELLEVILLE, IL 62223-5000
(618) 234-0640
(314) 851-4475
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(618) 234-0640
(314) 851-4475
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036067867
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010038
ESSENCE
IL
01
—
036067867
ILLINOIS PUBLIC AID
IL
05
—
036067867
—
IL
01
—
0455346
UHC
IL
01
—
118517
HEALTHLINK
IL
01
—
127482
GHP
IL
01
—
132702
BCBS TRI ST
IL
01
—
5812269
AETNA
IL
01
—
E20962
MERCY
IL
Enumeration date
11/16/2005
Last updated
10/24/2012
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