Backstrom, Dennis
Backstrom, Dennis is an individual health care provider with primary practice located at 1600 W Walnut St , Jacksonville IL 62650-1136. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Backstrom, Dennis can be contacted via phone (217) 245-9541.Contact Information
Primary practice address
1600 W Walnut St
Jacksonville IL 62650-1136
Phone: (217) 245-9541
Fax: (217) 479-8781
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | Illinois |
Profile Details
| NPI number | 1497892012 |
|---|---|
| LBN Legal business name | Backstrom, Dennis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497892012 | NPPES |
| Illinois | Other | 049626 | HEALTH ALLIANCE |
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