Individual
GLENN STECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
611 N CRAIG DR, MAHOMET, IL 61853-9054
(217) 621-9550
Mailing address
611 N CRAIG DR, MAHOMET, IL 61853-9054
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209002404
IL
Other
Enumeration date
10/01/2007
Last updated
10/01/2007
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