Provider Demographics
NPI:1306980743
Name:STESLOW, RICHARD (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:STESLOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 OGDEN AVE.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4386
Mailing Address - Country:US
Mailing Address - Phone:630-236-4300
Mailing Address - Fax:630-236-4302
Practice Address - Street 1:2020 OGDEN AVE.
Practice Address - Street 2:SUITE 400
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4386
Practice Address - Country:US
Practice Address - Phone:630-236-4300
Practice Address - Fax:630-236-4302
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL080039473OtherMEDICARE RRW
IL9915169OtherBCBS
IL9915169OtherBCBS