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General NPI Number Information
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NPI Number | 1952139941
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Entity Type | Individual
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Provider Name | COLTON MICHAEL STEIDINGER FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 1111 TRINITY LN STE 111
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City | BLOOMINGTON
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State | IL
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Zip | 61704-8112
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Country | US
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Telephone | 309-608-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 TRINITY LN STE 111
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City | BLOOMINGTON
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State | IL
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Zip | 61704-8112
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Country | US
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Telephone | 309-608-5100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209030074
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 1548276256
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License Number State | IL
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