Individual
DR. STEPHEN E BASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6161 N TRAILS END, PEORIA, IL 61614-3524
(309) 692-2664
(309) 692-2664
Mailing address
6161 N TRAILS END, PEORIA, IL 61614-3524
(309) 692-2664
(309) 692-2664
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
036-070694
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036070694
—
IL
Enumeration date
10/03/2006
Last updated
12/09/2020
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