Organization
JAMES T NIEMEYER DO SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES T NIEMEYER DO (OWNER / PHYSICIAN)
(815) 485-5388
Entity
Organization
Contact information
Practice address
600 E LINCOLN HWY, NEW LENOX, IL 60451-1911
(815) 485-5388
Mailing address
600 E LINCOLN HWY, NEW LENOX, IL 60451-1911
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009932143
BC/BS
IL
Enumeration date
05/26/2006
Last updated
08/10/2009
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