Stam, Douglas M
Stam, Douglas M is an sole proprietor health care provider with primary practice located at 396 Belle Aire Ave , Bourbonnais IL 60914-2010. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Stam, Douglas M can be contacted via phone (815) 933-7391.Contact Information
Primary practice address
396 Belle Aire Ave
Bourbonnais IL 60914-2010
Phone: (815) 933-7391
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Sports Physician | 111NS0005X | Illinois |
Profile Details
| NPI number | 1568576114 |
|---|---|
| LBN Legal business name | Stam, Douglas M |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Sep 6th, 2023 - about last year |
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 | 1568576114 | NPPES |
| Illinois | Other | 0004682104 | BC/BS NUMBER |
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