Stevens, Michael Wayne

Stevens, Michael Wayne is an sole proprietor health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-5243. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Stevens, Michael Wayne can be contacted via phone (093) 655-2000.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637-5243
Phone: (093) 655-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 125068180 Illinois
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 4301501740 Michigan
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 036.163090 Illinois

Profile Details

NPI number 1700249026
LBN Legal business name Stevens, Michael Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 4th, 2016
Last updated Jul 5th, 2023 - about 2 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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