Individual ProviderStephen A HermesInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address400 S Kennedy Dr, Suite 200, Bradley, IL 60915-2682(815) 933-0007PECOS EnrollmentBased on the most recent information from CMS, provider Stephen A Hermes does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1225071152Provider TypeIndividualFull NameHermes, Stephen ACredentialMDGenderMaleSole ProprietorYesEnumeration Date6/14/2006Last Updated3/24/2008Contact InformationPractice LocationPractice Address400 S Kennedy Dr, Suite 200, Bradley, IL 60915-2682Phone(815) 933-0007Fax(815) 933-2776Mailing LocationMailing Address400 S Kennedy Dr, Suite 200, Bradley, IL 60915-2682Phone(815) 933-0007Fax(815) 933-2776Provider TaxonomiesCodeDescriptionLicenseCode207RG0300XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense036056725IllinoisProvider IdentifiersIDDescriptionIssuerID791113742DescriptionOtherIssuerRAILROAD MEDICAREIllinoisID174184DescriptionOtherIssuerFEDERAL BLACK LUNGIllinoisID4600191DescriptionOtherIssuerBLUE CROSS/BLUE SHIELDIllinoisID036056725DescriptionMedicaidIssuerUnlistedIllinoisID5043293DescriptionOtherIssuerAETNAIllinois