Stavig, Rolf R

Stavig, Rolf R is an individual health care provider with primary practice located at 820 S Il Route 59 Suite A, Bartlett IL 60103-1694. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Stavig, Rolf R can be contacted via phone (630) 483-5930.

Contact Information

Primary practice address
820 S Il Route 59 Suite A Bartlett IL 60103-1694
Phone: (630) 483-5930
Fax: (630) 483-5939
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036075767 Illinois

Profile Details

NPI number 1265462089
LBN Legal business name Stavig, Rolf R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated May 2nd, 2012 - about 13 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 1265462089 NPPES
Illinois Other 3631498336019001 CDPG HFS PAYEE ID
Illinois Other 0222075 CDPG HFS PAYEE ID
Illinois Other 36-3149833 CDPG HFS PAYEE ID
Illinois MEDICAID 036075767 CDPG HFS PAYEE ID

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