Healthcare Provider Details

I. General information

NPI: 1598840423
Provider Name (Legal Business Name): STERLING ROCK FALLS CLINIC, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 08/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E MILLER RD
STERLING IL
61081-1252
US

IV. Provider business mailing address

101 E MILLER RD
STERLING IL
61081-1252
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State

VIII. Authorized Official

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