Dr. Jeremy W Henrichs
Family Doctor - Sports Medicine
810 W. Anthony Drive
Urbana
, Illinois 61801-7431
Dr. Jeremy W Henrichs
Family Doctor - Sports Medicine
810 W. Anthony Drive
Urbana
, Illinois 61801-7431
(217) 379-2604
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Jeremy W Henrichs
- Po Box 6002
- Urbana, IL
- Zip : 61803-6002
- Fax : (217) 379-2604
- Phone : (217) 326-8630
Second Address
- Dr. Jeremy W Henrichs
- 810 W. Anthony Drive
- Urbana, IL
- Zip : 61801-7431
- Fax : (217) 326-0210
- Phone : (217) 326-2255
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | 03611190 | IL |
National Provider Identifier
| NPI | 1154326759 |
|---|---|
| Provider Name | Dr. Jeremy W Henrichs |
| First Address | Urbana, IL 61803-6002 |
| Second Address | Urbana, IL 61801-7431 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/06/2005 |
| Last Update Date | 22/05/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036111690 | (05) | IL |
| H42573 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.