Organization
JAMES R. HERRON, MD, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES R. HERRON MD (PRESIDENT)
(312) 291-9083
Entity
Organization
Contact information
Practice address
1030 N CLARK ST, STE 647, CHICAGO, IL 60610-5467
(312) 291-9083
(312) 624-9183
Mailing address
4008 CHESTER DR, GLENVIEW, IL 60026-1047
(312) 291-9083
(312) 624-9183
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
042002026
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036047483
—
IL
Enumeration date
12/19/2007
Last updated
08/19/2011
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