MEDICARE: DR. TIMOTHY STEGEMANN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	20A9687	CA
2	207Q00000X	Family Medicine Physician	0368127891	IL

General Provider Information

NPI Number	:	1861557399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY STEGEMANN

Provider Business Mailing Address
First Line	:	30 TOWER CT
Second Line	:	SUITE C
City	:	GURNEE
State	:	IL
Zip	:	60031-3322
Country	:	US
Telephone Number	:	847-599-0715
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 TOWER CT
Second Line	:	SUITE C
City	:	GURNEE
State	:	IL
Zip	:	60031-3322
Country	:	US
Telephone Number	:	847-599-0715
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	01/25/2013

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Directions to “ DR. TIMOTHY STEGEMANN ” Practice Location

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