Individual
STEPHANIE A MODERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO MPH
Contact information
Practice address
676 N SAINT CLAIR ST STE 2330, CHICAGO, IL 60611-2915
(312) 926-6895
Mailing address
2411 RICHVIEW RD, MOUNT VERNON, IL 62864-2740
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.175607
IL
208M00000X
Hospitalist Physician
Primary
036175607
IL
Other
Enumeration date
05/24/2022
Last updated
12/01/2025
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