Stevens, Douglas S

Stevens, Douglas S is an individual health care provider with primary practice located at 12701 W 143Rd St Suite 200, Homer Glen IL 60491-7715. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Stevens, Douglas S can be contacted via phone (877) 694-7722.

Contact Information

Primary practice address
12701 W 143Rd St Suite 200 Homer Glen IL 60491-7715
Phone: (877) 694-7722
Fax: (815) 531-0055
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085001302 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X IL085-001302 Illinois

Profile Details

NPI number 1881673085
LBN Legal business name Stevens, Douglas S
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2006
Last updated Nov 7th, 2016 - about 8 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 1881673085 NPPES
Illinois Other 085001302 STATE LICENSE NUMBER

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