Individual
DR. EMERITO FERNANDEZ URETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 N CALDWELL ST, STAUNTON, IL 62088-1421
(618) 635-2221
(618) 635-2269
Mailing address
400 N CALDWELL ST, STAUNTON, IL 62088-1499
(618) 635-2200
(618) 635-4244
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036045117
IL
208600000X
Surgery Physician
036045117
IL
208D00000X
General Practice Physician
036045117
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036045117
—
IL
Enumeration date
10/16/2006
Last updated
10/24/2018
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