Healthcare Provider Details

I. General information

NPI: 1346475159
Provider Name (Legal Business Name): STERLING ROCK FALLS CLINIC, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2009
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 W 3RD ST
STERLING IL
61081-3503
US

IV. Provider business mailing address

101 E MILLER RD
STERLING IL
61081-1252
US

V. Phone/Fax

Practice location:
  • Phone: 815-632-5300
  • Fax:
Mailing address:
  • Phone: 815-625-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY LEMAY
Title or Position: PRES.-BOARD OF DIRECTORS
Credential: M.D.
Phone: 815-625-4790