Van Zant, Roberta

Van Zant, Roberta is an individual health care provider with primary practice located at 104 E Queenwood Rd Ste 202 , Morton IL 61550-2962. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Van Zant, Roberta can be contacted via phone (309) 621-9580.

Contact Information

Primary practice address
104 E Queenwood Rd Ste 202 Morton IL 61550-2962
Fax: (309) 291-0558
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036109306 Illinois

Profile Details

NPI number 1497762587
LBN Legal business name Van Zant, Roberta
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Oct 26th, 2021 - about 3 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 1497762587 NPPES
Illinois MEDICAID 0351093061

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