Mccuiston, Stonewall

Mccuiston, Stonewall is an individual health care provider with primary practice located at 375 N Wall St Ste P310 , Kankakee IL 60901-3484. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Mccuiston, Stonewall can be contacted via phone (815) 933-0194.

Contact Information

Primary practice address
375 N Wall St Ste P310 Kankakee IL 60901-3484
Phone: (815) 933-0194
Fax: (815) 936-3847
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036074737 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036074737 Illinois

Profile Details

NPI number 1720072143
LBN Legal business name Mccuiston, Stonewall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Mar 29th, 2021 - about 5 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 1720072143 NPPES
Illinois Other 4623239 BLUE CROSS AND BLUE SHIELD OF ILLINOIS
Illinois MEDICAID 036074737 BLUE CROSS AND BLUE SHIELD OF ILLINOIS

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