| |
2020 Ogden Ave. Suite 400 Aurora IL 60504-4386 | |
(630) 236-4300 | |
(630) 236-4302 |
Full Name | |
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Speciality | Family Medicine |
Location | 2020 Ogden Ave., Aurora, Illinois |
Authorized Official Name and Position | Richard J Steslow (OWNER/PRESIDENT/PHYSICIAN) |
Authorized Official Contact | 6302364300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2020 Ogden Ave. Suite 400 Aurora IL 60504-4386 Ph: (630) 236-4300 | 2020 Ogden Ave. Suite 400 Aurora IL 60504-4386 Ph: (630) 236-4300 |
NPI Number | 1306066097 |
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Provider Enumeration Date | 04/26/2007 |
Last Update Date | 11/09/2016 |
Medicare PECOS PAC ID | 0244209641 |
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Medicare Enrollment ID | O20041001000650 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306066097 | NPI | - | NPPES |
9915169 | Other | IL | BCBS |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 036085042 (Illinois) | Primary |
Provider Name | Richard J Steslow |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306980743 PECOS PAC ID: 7416926811 Enrollment ID: I20041004000027 |
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