Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Stuart

Individual provider Physician Assistant · NPI 1417372772

Mary Stuart is a Physician Assistant in Alton, Illinois. Qualified in 2013, 13 years ago. Practices with Fairview Heights Medical Group SC, a 448-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
13
Licensed in
IL
In the registry since
2014

Practice location Address checks out

4 Memorial Dr Ste 130B
Alton, IL 62002-6751
Phone: (618) 463-7600
Fax: (618) 463-7601
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.004857 (IL)

Record details

NPI number1417372772
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 24, 2014
Last updated in NPPESFebruary 28, 2021
Certification dateFebruary 28, 2021
Mailing address670 Mason Ridge Center Dr, Ste 300, Saint Louis, MO 63141-8573

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Fairview Heights Medical Group Sc — 448 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Alton