Individual
STEVEN O IKENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 ROXBURY RD, ROCKFORD, IL 61107-5075
(815) 397-7340
(815) 397-7388
Mailing address
401 ROXBURY RD, ROCKFORD, IL 61107-5075
(815) 397-7340
(815) 397-7388
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
01039865A
IN
207RG0100X
Gastroenterology Physician
Primary
36093860
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093860
—
IL
Enumeration date
09/22/2005
Last updated
12/22/2010
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