Ojhanae Stallworth, is a medicare enrolled "Student In An Organized Health Care Education/training Program" in North Chicago, Illinois. She graduated from nursing school in 2023 and has 3 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Endeavor Health Medical Group and 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
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1710661053.
Provider's Profile
| Full Name | Ojhanae Stallworth |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 3 Years |
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| Location | 3101 22nd Pl, North Chicago, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ojhanae Stallworth graduated from nursing school in 2023
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 |
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| 363A00000X | Physician Assistant | 085010207 (Illinois) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Endeavor Health Medical Group | 2163334699 | 3022 |
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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