IndividualActive
Joan Selburg, CST
NPI 1063538940 · Surgical Technologist · Peoria, IL
Provider details
- NPI number
- 1063538940
- Entity type
- Individual
- Primary specialty
- Surgical TechnologistTechnologists, Technicians & Other Technical Service Providers
- Credential
- CST
- Sex
- Female
- Sole proprietor
- No
- License
- 102326 (IL)
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
120 Ne Glen Oak Ave
Suite 407
Peoria, IL 61603-4301
Phone: (309) 672-5975
Fax: (309) 655-1678
Approximate (ZIP-level) locationGet directions
Mailing address
120 Ne Glen Oak Ave
Peoria, IL 61603-4301
Registry dates
- Enumerated
- 2007-03-22
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.