Provider Demographics
NPI:1053470559
Name:STEWART, VALLI P (MD)
Entity Type:Individual
Prefix:
First Name:VALLI
Middle Name:P
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:EVANSTON HOSPITAL
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-1206
Mailing Address - Fax:847-570-1248
Practice Address - Street 1:1000 CENTRAL ST
Practice Address - Street 2:SUITE 640
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1777
Practice Address - Country:US
Practice Address - Phone:847-570-1410
Practice Address - Fax:847-869-0520
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2020-12-17
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Provider Licenses
StateLicense IDTaxonomies
IL036-086970207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF79217Medicare UPIN