Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 036104352 | IL |
Y | 207X00000X | Orthopaedic Surgeon | 34112 | MN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 036104352 | IL |
NPI | 1114913944 |
---|---|
Provider Name | Debra Ann Zillmer |
First Address | Rochester, MN 55905 |
Second Address | Rochester, MN 55905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 12/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036104352 | (05) | IL |
200042818 | RAILROAD MEDICARE (01) | IL |
B21160 | (02) | |
E07336 | (02) | IL |
ENROLLED | (05) | MN |
P00948581 | RAILROAD MEDICARE (01) | MN |