Provider Demographics
NPI:1982348405
Name:STEIDINGER, JASON ALEX
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ALEX
Last Name:STEIDINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PRATT ST
Mailing Address - Street 2:
Mailing Address - City:CROPSEY
Mailing Address - State:IL
Mailing Address - Zip Code:61731-7508
Mailing Address - Country:US
Mailing Address - Phone:309-532-9686
Mailing Address - Fax:
Practice Address - Street 1:104 PRATT ST
Practice Address - Street 2:
Practice Address - City:CROPSEY
Practice Address - State:IL
Practice Address - Zip Code:61731-7508
Practice Address - Country:US
Practice Address - Phone:309-532-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty