STILLWATER HEALTH PLLC – NPI #1891642179
Family Medicine

A family medicine physician who specializes in the diagnosis and treatment of addictions.

Health Care Provider Taxonomy Code for Family Medicine

STILLWATER HEALTH PLLC is a provider located in CHICAGO, IL. NPPES recently assigned the NPI number 1891642179 to STILLWATER HEALTH PLLC on March 14, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207QA0401X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Addiction Medicine

The NPI profile was last updated on May 12, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for STILLWATER HEALTH PLLC below.

NPI Profile for
STILLWATER HEALTH PLLC

NPI Number
1891642179
Enumeration Date

(about 3 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
STILLWATER HEALTH PLLC
Primary location
3256 W POTOMAC AVE
CHICAGO, IL 60651-2411
Phone: (708) 280-6164 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
CAROLLE DERRADJI
OWNER
Phone: (708) 280-6164
Updated
Certification Date
May 12, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0401X
- Family Medicine / Addiction Medicine (Primary)
363LP0808X
- Nurse Practitioner / Psychiatric/Mental Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.