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Individual

DR. JEREMY SHANE STEVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1004 HEALTH CENTER DR STE 100, MATTOON, IL 61938-9253
(217) 238-3435
(217) 238-3492
Mailing address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4693
(217) 238-6055
(217) 258-2216

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-111903
IL
207X00000X
Orthopaedic Surgery Physician
231357
MA

Other

Enumeration date
07/05/2005
Last updated
01/08/2019
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