Individual
DR. STEPHANIE ANN VAN ULFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
901 W JEFFERSON ST, SPRINGFIELD, IL 62702-4833
(217) 545-8000
(217) 545-2275
Mailing address
901 W JEFFERSON ST, PO BOX 19642, SPRINGFIELD, IL 62702-4833
(217) 545-8000
(217) 545-2275
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036101761
IL
2084P0805X
Geriatric Psychiatry Physician
Primary
036101761
IL
Other
Enumeration date
09/21/2005
Last updated
12/07/2020
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