Individual
DR. LUKE HERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 N ROCKTON AVE, ROCKFORD, IL 61103-3619
(815) 971-2000
(815) 972-1092
Mailing address
2300 N ROCKTON AVE, ROCKFORD, IL 61103-3619
(815) 971-2000
(815) 972-1092
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036126211
IL
390200000X
Student in an Organized Health Care Education/Training Program
125053077
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
769380
MEDICARE PTAN GROUP
IL
Enumeration date
09/05/2008
Last updated
09/12/2011
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