Doughty, Stephen C

Doughty, Stephen C is an individual health care provider with primary practice located at 1120 E War Memorial Dr , Peoria Heights IL 61616-7757. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Doughty, Stephen C can be contacted via phone (888) 220-6432.

Contact Information

Primary practice address
1120 E War Memorial Dr Peoria Heights IL 61616-7757
Phone: (888) 220-6432
Fax: (630) 654-4253
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 036-055284 Illinois

Profile Details

NPI number 1255327631
LBN Legal business name Doughty, Stephen C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated May 13th, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255327631 NPPES
Illinois MEDICAID 036-055-284

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