Individual ProviderStephen R HumowieckiFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1100 Lake St, Suite 210, Oak Park, IL 60301-1015(708) 848-4188PECOS EnrollmentBased on the most recent information from CMS, provider Stephen R Humowiecki 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 2 days ago.Profile DetailsProvider ID1477533560Provider TypeIndividualFull NameHumowiecki, Stephen RCredentialMDGenderMaleSole ProprietorNoEnumeration Date1/17/2006Last Updated7/22/2008Contact InformationPractice LocationPractice Address1100 Lake St, Suite 210, Oak Park, IL 60301-1015Phone(708) 848-4188Fax(708) 524-2142Mailing LocationMailing Address1100 Lake St, Suite 210, Oak Park, IL 60301-1015Phone(708) 848-4188Fax(708) 524-2142Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense036053573IllinoisProvider IdentifiersIDDescriptionIssuerID01615849DescriptionOtherIssuerBCBSIllinoisID036053572DescriptionMedicaidIssuerUnlistedIllinois