Healthcare Provider Details

I. General information

NPI: 1194919522
Provider Name (Legal Business Name): WILLIAM ZIMMER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N 8TH ST SUITE 1 B201
SPRINGFIELD IL
62701-1041
US

IV. Provider business mailing address

801 E CARPENTER ST PO BOX 1977
SPRINGFIELD IL
62702-5323
US

V. Phone/Fax

Practice location:
  • Phone: 217-535-3799
  • Fax: 217-525-5685
Mailing address:
  • Phone: 217-544-6464
  • Fax: 217-757-6021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. WILLIAM R ZIMMER
Title or Position: OWNER
Credential: MD
Phone: 217-544-6464