MEDICARE: ELDON TRAME M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036070362	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036070362	OTHER	IL	ILLINOIS PUBLIC AID
2	0450288	OTHER	IL	UHC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	D15805	OTHER	IL	MERCY
5	127497	OTHER		GHP
6	132982	OTHER	IL	BCBS TRI ST
7	5971061	OTHER	IL	AETNA
8	000000010040	OTHER	IL	ESSENCE
9	118457	OTHER	IL	HEALTHLINK
10	8221955	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1033192299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELDON TRAME M.D.

Provider Business Mailing Address
First Line	:	PO BOX 23340
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63156-3340
Country	:	US
Telephone Number	:	618-234-0640
Fax Number	:	314-851-4475

Provider Business Practice Location Address
First Line	:	2900 FRANK SCOTT PKWY W
Second Line	:	SUITE 904
City	:	BELLEVILLE
State	:	IL
Zip	:	62223-5000
Country	:	US
Telephone Number	:	618-234-0640
Fax Number	:	314-851-4475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	10/01/2012

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Directions to “ ELDON TRAME M.D.” Practice Location

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