Individual
DR. DANIEL R HERDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3505 NORTH BELL SCHOOL ROAD, ROCKFORD, IL 61114
(779) 696-0300
Mailing address
PO BOX 1567, ROCKFORD, IL 61110-0067
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036081171
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081171
—
IL
Enumeration date
06/14/2006
Last updated
02/19/2021
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