Individual
STEPHEN J TALTY
Active
Individual
STEPHEN J TALTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036080186
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618781
BC/BS
IL
05
—
036080186
—
IL
01
—
250003386
MEDICARE RAILROAD
IL
Enumeration date
12/14/2005
Last updated
10/13/2020
Update your record
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