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

Stefanie Poettker

Individual provider Nurse Practitioner · NPI 1376417253

Stefanie Poettker is a Nurse Practitioner in Herrin, Illinois. Qualified in 2021, 5 years ago. Practices with Southern Orthopedic Associates SC, a 27-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2025

Practice location Address checks out

510 Lincoln Dr
Herrin, IL 62948-6334
Phone: (618) 997-6800
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209.033426 (IL)

Record details

NPI number1376417253
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 2, 2025
Last updated in NPPESOctober 2, 2025
Certification dateSeptember 3, 2025
Mailing address15487 E Tolle Rd, Mount Vernon, IL 62864-8364

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Southern Orthopedic Associates Sc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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