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
Phone: (309) 621-9580
Fax: (309) 291-0558
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1497762587 | NPPES |
Illinois | MEDICAID | 0351093061 |
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