Individual
JAMES T NIEMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
250 E MAPLE ST, NEW LENOX, IL 60451-1871
(815) 485-0760
(815) 463-6138
Mailing address
PO BOX 1184, BEDFORD PARK, IL 60499-1184
(815) 485-0760
(815) 463-6138
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036084801
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036084801
—
IL
Enumeration date
07/05/2005
Last updated
10/15/2012
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