Individual
DR. HANEME IDRIZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
415 N 9TH ST, SPRINGFIELD, IL 62702
(217) 545-8000
(217) 757-6654
Mailing address
PO BOX 19661, SPRINGFIELD, IL 62794-9661
(217) 545-8000
(217) 757-6654
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-146308
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-146308
STATE LICENSE
IL
Enumeration date
06/17/2006
Last updated
06/27/2018
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