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Individual

PATRICK R HEMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-0001
(217) 544-6464
Mailing address
PO BOX 10200, PEORIA, IL 61612-0200

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036114938
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011112
HEALTH ALLIANCE
IL
01
020102500
BLACK LUNG
IL
05
036114938
IL
01
14D0435736
CLIA
IL
01
32017
PERSONAL CARE ID
IL
01
684895
HEALTHLINK
IL
01
P00327016
RAILROAD MEDICARE PIN
IL
Enumeration date
01/31/2006
Last updated
05/12/2011
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