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Individual

JEFFREY E. STEDWILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 NE RANDOLPH AVE, PEORIA, IL 61606-1919
(309) 624-8550
(309) 624-8697
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
(309) 655-7869

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036-096932
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
815940
MEDICARE GROUP NO.
Enumeration date
07/20/2006
Last updated
07/08/2007
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