Provider Demographics
NPI:1477592194
Name:MUELLER, STEPHEN V (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:V
Last Name:MUELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 S 3RD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-1952
Mailing Address - Country:US
Mailing Address - Phone:618-233-0017
Mailing Address - Fax:618-233-0251
Practice Address - Street 1:180 S 3RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1952
Practice Address - Country:US
Practice Address - Phone:618-233-0017
Practice Address - Fax:618-233-0251
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036048229207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL244403684OtherGROUP HEALTH PLAN
IL0707048OtherUHC MEDICARE COMPLETE
IL036048229Medicaid
IL821512OtherBC/BS
IL105592OtherALLIANCE BC/BS
ILC37071Medicare UPIN
IL244403684OtherGROUP HEALTH PLAN