Stevens, Michael Wayne
Stevens, Michael Wayne is an sole proprietor health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-5243. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Stevens, Michael Wayne can be contacted via phone (093) 655-2000.Contact Information
Primary practice address
530 Ne Glen Oak Ave
Peoria IL 61637-5243
Phone: (093) 655-2000
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 125068180 | Illinois |
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | 4301501740 | Michigan |
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | 036.163090 | Illinois |
Profile Details
NPI number | 1700249026 |
---|---|
LBN Legal business name | Stevens, Michael Wayne |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 4th, 2016 |
Last updated | Jul 5th, 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.
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