Healthcare Provider Details

I. General information

NPI: 1134169675
Provider Name (Legal Business Name): JAMES A. HEJMANOWSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 10/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E. LEFEVRE ROAD
STERLING IL
61081-1279
US

IV. Provider business mailing address

2221 ELM ST
RAWLINS WY
82301-5108
US

V. Phone/Fax

Practice location:
  • Phone: 815-625-0400
  • Fax: 815-625-2747
Mailing address:
  • Phone: 307-324-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number9834A
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036091862
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: