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Individual

MICHAEL PAUL BEDNARZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1601 WEST JACKSON STREET, SUITE 104, MACOMB, IL 61455
(309) 575-3222
(309) 404-8000
Mailing address
1601 WEST JACKSON STREET, SUITE 104, MACOMB, IL 61455
(309) 575-3222
(309) 404-8000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036100780
IL
2084P0800X
Psychiatry Physician
Primary
36100780
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036100780
IL
Enumeration date
06/02/2006
Last updated
04/21/2021
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