Roehm, Stephen C
Roehm, Stephen C is an sole proprietor health care provider with primary practice located at 5006 N University St , Peoria IL 61614-4715. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Roehm, Stephen C can be contacted via phone (309) 691-9665.Contact Information
Primary practice address
5006 N University St
Peoria IL 61614-4715
Phone: (309) 691-9665
Fax: (309) 691-9680
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 1915903 | Illinois |
Profile Details
| NPI number | 1902058985 |
|---|---|
| LBN Legal business name | Roehm, Stephen C |
| Credentials | D.D.S., M.S. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 21st, 2008 |
| Last updated | Oct 21st, 2008 - 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 | 1902058985 | NPPES |
| Illinois | MEDICAID | 1004551 |
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