Individual
APIWAT FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3707 DOTY RD, WOODSTOCK, IL 60098-7530
(815) 338-6600
Mailing address
3707 DOTY RD, WOODSTOCK, IL 60098-7530
(815) 338-6600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036081772
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081772
—
IL
01
—
04532206
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/14/2005
Last updated
07/21/2022
About Stedi
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