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General NPI Number Information
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NPI Number | 1346475159
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Entity Type | Organization
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Legal Business Name | STERLING ROCK FALLS CLINIC, LTD
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 10 W 3RD ST
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City | STERLING
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State | IL
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Zip | 61081-3503
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Country | US
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Telephone | 815-632-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E MILLER RD
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City | STERLING
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State | IL
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Zip | 61081-1252
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Country | US
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Telephone | 815-625-4790
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Fax |
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Authorized Official
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Title or Position | PRES.-BOARD OF DIRECTORS
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Name | DR. JEFFREY LEMAY
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Credential | M.D.
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Telephone | 815-625-4790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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