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Contact Information

STEPHEN E BASH, MD
6161 N TRAILS END
PEORIA, IL61614-3524
 Phone: 309-692-2664
 Fax: 309-692-2664
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for STEPHEN E BASH · (Male)

NPI Number 1417041666
Status Active
Credentials MD
Entity Individual
Enumeration date 10/03/2006
Last updated 12/09/2020 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 036-070694
  • IL Medicaid 036070694
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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