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Individual

DR. JAMES J SIEGERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
20201 CRAWFORD AVE, SUITE 1276, OLYMPIA FIELDS, IL 60461-1010
(708) 679-2270
Mailing address
35318 EAGLE WAY, CHICAGO, IL 60678-1353
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036137110
IL
208800000X
Urology Physician
Primary
036-137110
IL
282N00000X
General Acute Care Hospital

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F400197142
MEDICARE PTAN
IL
01
F400228923
MEDICARE PTAN
IL
Enumeration date
04/15/2010
Last updated
03/20/2021
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