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Organization
MYS - ROCHELLE LLC
Active
Organization
MYS - ROCHELLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD STERN (OWNER)
(815) 398-3879
Entity
Organization
Contact information
Practice address
1001 LINCOLN HWY, ROCHELLE, IL 61068-1514
(815) 562-2030
Mailing address
1001 LINCOLN HWY, ROCHELLE, IL 61068-1514
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
019021620
IL
261QD0000X
Dental Clinic/Center
Primary
019024307
IL
261QD0000X
Dental Clinic/Center
019030473
IL
Other
Enumeration date
12/23/2015
Last updated
06/19/2017
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