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Organization

NORTHERN ILLINOIS VEIN CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD STEFFEN MD (MD)
(815) 316-8346
Entity
Organization

Contact information

Practice address
1340 CHARLES ST, SUITE 404, ROCKFORD, IL 61104-2200
(815) 316-8346
Mailing address
PO BOX 4632, ROCKFORD, IL 61110-4632
(815) 391-7285

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Enumeration date
03/09/2006
Last updated
12/05/2007
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