Stachniw, Myron B
Stachniw, Myron B is an individual health care provider with primary practice located at 6000 N Allen Rd , Peoria IL 61614-3294. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Stachniw, Myron B can be contacted via phone (309) 691-1400.Contact Information
Primary practice address
6000 N Allen Rd
Peoria IL 61614-3294
Phone: (309) 691-1400
Fax: (309) 693-3197
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 036049846 | Illinois |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 36049846 | Illinois |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 036049846 | Illinois |
Profile Details
| NPI number | 1114911377 |
|---|---|
| LBN Legal business name | Stachniw, Myron B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 2nd, 2005 |
| Last updated | Aug 1st, 2022 - about 4 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 | 1114911377 | NPPES |
| Illinois | MEDICAID | 036049846 |
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