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

Ojhanae Stallworth

Individual provider Physician Assistant · NPI 1710661053

Ojhanae Stallworth is a Physician Assistant in Evanston, Illinois. Qualified in 2023, 3 years ago. Practices with Endeavor Health Medical Group, a 3,348-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone: (847) 570-2040
Fax: (847) 733-5315
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 085010207 (IL)
Physician Assistant Taxonomy 363A00000X · Licence 085010207 (IL)

Record details

NPI number1710661053
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 14, 2023
Last updated in NPPESMarch 12, 2026
Certification dateMarch 12, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Endeavor Health Medical Group — 3348 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Evanston