Provider Demographics
NPI:1164545471
Name:STEC, AUGUSTYN (MD)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTYN
Middle Name:
Last Name:STEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5430 S KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60632-2620
Mailing Address - Country:US
Mailing Address - Phone:773-778-2880
Mailing Address - Fax:
Practice Address - Street 1:5430 S KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-2620
Practice Address - Country:US
Practice Address - Phone:773-778-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD12012Medicare UPIN
IL487401Medicare ID - Type Unspecified