Ikenberry, Steven O

Ikenberry, Steven O is an individual health care provider with primary practice located at 401 Roxbury Rd , Rockford IL 61107-5075. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Ikenberry, Steven O can be contacted via phone (815) 397-7340.

Contact Information

Primary practice address
401 Roxbury Rd Rockford IL 61107-5075
Fax: (815) 397-7388
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 36093860 Illinois
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 01039865A Indiana

Profile Details

NPI number 1336135540
LBN Legal business name Ikenberry, Steven O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2005
Last updated Dec 22nd, 2010 - about 14 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 1336135540 NPPES
Illinois MEDICAID 036093860

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