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Individual

DUSTIN STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
270 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2004
(618) 498-7108
(618) 498-7919
Mailing address
390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2000
(618) 498-7518
(618) 498-3052

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036175655
IL
207Q00000X
Family Medicine Physician
65330
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15007422
CAQH
IL
Enumeration date
05/18/2014
Last updated
07/29/2025
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