Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 036063933 | IL |
NPI | 1053330993 |
---|---|
Provider Name | James R Egner |
First Address | Urbana, IL 61803 |
Second Address | Urbana, IL 61801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 24/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0533210001 | DMERC (01) | IL |
900000138 | RAILROAD (01) | IL |
C43425 | (02) | |
C43425 | (02) | IL |