| James R. Herron, Md, Ltd | |
|
1030 N Clark St Ste 647 Chicago IL 60610-5467 | |
| (312) 291-9083 | |
| (312) 624-9183 |
| Full Name | James R. Herron, Md, Ltd |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1030 N Clark St, Chicago, Illinois |
| Authorized Official Name and Position | James R. Herron (PRESIDENT) |
| Authorized Official Contact | 3122919083 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James R. Herron, Md, Ltd 4008 Chester Dr Glenview IL 60026-1047 Ph: (312) 291-9083 | James R. Herron, Md, Ltd 1030 N Clark St Ste 647 Chicago IL 60610-5467 Ph: (312) 291-9083 |
| NPI Number | 1699959262 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 08/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699959262 | NPI | - | NPPES |
| 036047483 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 042002026 (Illinois) | Primary |
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