Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 363816770 | IL |
NPI | 1376650135 |
---|---|
Provider Name | Dr. Michael James Riermaier |
First Address | Elgin, IL 60123-2304 |
Second Address | Elgin, IL 60123-2304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 18/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036065268 | (05) | IL |
C38286 | (02) | IL |