Stachniw, Myron B

Stachniw, Myron B is an individual health care provider with primary practice located at 6000 N Allen Rd , Peoria IL 61614-3294. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Stachniw, Myron B can be contacted via phone (309) 691-1400.

Contact Information

Primary practice address
6000 N Allen Rd Peoria IL 61614-3294
Phone: (309) 691-1400
Fax: (309) 693-3197
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036049846 Illinois
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 36049846 Illinois
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036049846 Illinois

Profile Details

NPI number 1114911377
LBN Legal business name Stachniw, Myron B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Aug 1st, 2022 - about 2 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 1114911377 NPPES
Illinois MEDICAID 036049846

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