Individual
MR. STEPHEN M SOLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1900 OGDEN AVE, SUITE 210, AURORA, IL 60504-4273
(630) 968-1881
(630) 968-1719
Mailing address
4300 COMMERCE CT, SUITE 230, LISLE, IL 60532-3698
(630) 968-1881
(630) 968-1719
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004570
IL
363AS0400X
Surgical Physician Assistant
085004570
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085004570
—
IL
01
—
970023229
RAILROAD MEDICARE
IL
Enumeration date
12/13/2012
Last updated
12/13/2012
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