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Dennis Backstrom, MD

Emergency Medicine in Jacksonville, IL. Individual provider (NPI-1).

NPI number1497892012
StatusActive
Last updated in NPPESJul 9, 2007

Details

NPI
1497892012
Entity type
Individual (NPI-1)
Name
Dennis Backstrom
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jan 31, 2007
Last updated
Jul 9, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency Medicine036058856ILYes

Practice location

1600 W Walnut St
Jacksonville, IL 62650-1136

Phone 217-245-9541 · Fax 217-479-8781

Mailing address

1600 W Walnut St
Jacksonville, IL 62650-1136

Phone 217-245-9541 · Fax 217-479-8781

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