Individual
STEPHEN A HERMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 S KENNEDY DR, SUITE 200, BRADLEY, IL 60915-2682
(815) 933-0007
(815) 933-2776
Mailing address
400 S KENNEDY DR, SUITE 200, BRADLEY, IL 60915-2682
(815) 933-0007
(815) 933-2776
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036056725
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036056725
—
IL
01
—
174184
FEDERAL BLACK LUNG
IL
01
—
4600191
BLUE CROSS/BLUE SHIELD
IL
01
—
5043293
AETNA
IL
01
—
791113742
RAILROAD MEDICARE
IL
Enumeration date
06/14/2006
Last updated
03/24/2008
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