Healthcare Provider Details

I. General information

NPI: 1518966811
Provider Name (Legal Business Name): ARNOLD J HERBSTMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 N RANDALL RD SUITE 140
ELGIN IL
60123-9401
US

IV. Provider business mailing address

1710 N RANDALL RD SUITE 140
ELGIN IL
60123-9401
US

V. Phone/Fax

Practice location:
  • Phone: 847-888-0750
  • Fax: 847-888-2152
Mailing address:
  • Phone: 847-888-0750
  • Fax: 847-888-2152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036-052271
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: