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NPI Code Detail

MEDICARE: MITCHELL LOUIS HEUERMANN MD

MEDICARE: MITCHELL LOUIS HEUERMANN MD
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
1207Y00000XOtolaryngology Physician2023047886MO
2207Y00000XOtolaryngology Physician036.164552IL

General Provider Information

NPI Number : 1295227783
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITCHELL LOUIS HEUERMANN MD
Provider Business Mailing Address
First Line : 720 N BOND ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62702-4952
Country : US
Telephone Number : 217-545-8000
Fax Number :
Provider Business Practice Location Address
First Line : 720 N BOND ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62702-4952
Country : US
Telephone Number : 309-265-1942
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2018
Last Update Date : 02/06/2026

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Directions to “ MITCHELL LOUIS HEUERMANN MD” Practice Location

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