Nitz, Stephen T

Nitz, Stephen T is an individual health care provider with primary practice located at 7177 Crimson Ridge Dr Ste 5, Rockford IL 61107-6235. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Nitz, Stephen T can be contacted via phone (815) 734-6061.

Contact Information

Primary practice address
7177 Crimson Ridge Dr Ste 5 Rockford IL 61107-6235
Phone: (815) 734-6061
Fax: (815) 734-9021
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036105695 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 57636 Wisconsin

Profile Details

NPI number 1518958651
LBN Legal business name Nitz, Stephen T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2005
Last updated Dec 12th, 2019 - about 7 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 1518958651 NPPES
Illinois Other 036105695 IL STATE LICENSE
Illinois MEDICAID 036105695 IL STATE LICENSE

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