Individual
MANORAMA HERMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 W 1ST ST, ROCK FALLS, IL 61071-1269
(815) 625-4790
Mailing address
101 E MILLER RD, STERLING, IL 61081-1252
(815) 625-4790
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011551
HEALTH ALLIANCE MEDICAL
IL
01
—
9815737
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/12/2006
Last updated
07/08/2007
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