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Individual

MR. JUSTIN MICHAEL STEULLET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
750 ALMAR PKWY, SUITE 205, BOURBONNAIS, IL 60914-2315
(815) 933-3955
(815) 933-3944
Mailing address
750 ALMAR PKWY, SUITE 205, BOURBONNAIS, IL 60914-2315
(815) 933-3955
(815) 933-3944

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
238.000177
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
238.000177
STATE REGISTRATION
IL
Enumeration date
11/09/2007
Last updated
11/09/2007
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