Ojhanae Stallworth, is a medicare enrolled "Student In An Organized Health Care Education/training Program" in North Chicago, Illinois. Her current practice location is
3101 22nd Pl, North Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at
(847) 406-6904.
Ojhanae Stallworth is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1710661053.
Provider's Profile
Full Name | Ojhanae Stallworth |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 3101 22nd Pl, North Chicago, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1710661053
- Provider Enumeration Date: 06/14/2023
- Last Update Date: 03/11/2024
Medicare PECOS Information:
- PECOS PAC ID: 5698115277
- Enrollment ID: I20240430001334
Medical Identifiers
Medical identifiers for Ojhanae Stallworth such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710661053 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 085010207 (Illinois) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ojhanae Stallworth is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ojhanae Stallworth, 3101 22nd Pl, North Chicago, IL 60064-2903 Ph: () - | Ojhanae Stallworth, 3101 22nd Pl, North Chicago, IL 60064-2903 Ph: (847) 406-6904 |
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