MEDICARE: DR. ERIC E SIMPSON D.O.

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	208800000X	Urology Physician	036147336	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	F400504224	OTHER	IL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134381650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC E SIMPSON D.O.

Provider Business Mailing Address
First Line	:	215 E 1ST ST STE 153
Second Line	:
City	:	DIXON
State	:	IL
Zip	:	61021-3175
Country	:	US
Telephone Number	:	815-285-5484
Fax Number	:	815-285-5486

Provider Business Practice Location Address
First Line	:	215 E 1ST ST STE 153
Second Line	:
City	:	DIXON
State	:	IL
Zip	:	61021-3175
Country	:	US
Telephone Number	:	815-285-5484
Fax Number	:	815-285-5486

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

Provider Enumeration Date	:	06/26/2008
Last Update Date	:	10/08/2019

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Directions to “ DR. ERIC E SIMPSON D.O.” Practice Location

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