Jennison, Stephen H

Jennison, Stephen H is an individual health care provider with primary practice located at 619 E Mason St Suite 4P57, Springfield IL 62701-1034. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Jennison, Stephen H can be contacted via phone (217) 788-0706.

Contact Information

Primary practice address
619 E Mason St Suite 4P57 Springfield IL 62701-1034
Fax: (217) 525-2535
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036-091807 Illinois

Profile Details

NPI number 1043391766
LBN Legal business name Jennison, Stephen H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jun 2nd, 2008 - about 16 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 1043391766 NPPES
Illinois Other 060031123 RAILROAD

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