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Organization

JAVIER MUNIZ, DO, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAVIER MUNIZ DO (OWNER)
(618) 942-5883
Entity
Organization

Contact information

Practice address
315 S 13TH ST, SUITE 2, HERRIN, IL 62948-3619
(618) 942-5883
(618) 942-5921
Mailing address
315 S 13TH ST, SUITE 2, HERRIN, IL 62948-3619
(618) 942-5883
(618) 942-5921

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036097846
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036097846
IL
01
10032009
BCBS
IL
01
101436
BLACK LUNG
IL
01
110245013
RR MEDICARE
IL
01
385740
HEALTHLINK
IL
01
39692
HEALTH ALLIANCE
IL
Enumeration date
07/21/2006
Last updated
07/11/2012
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