Herzog, Brett Howard

Herzog, Brett Howard is an individual health care provider with primary practice located at 1418 Cross St Div Im Medical Oncology, Ste 180, Shiloh IL 62269-2914. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Medical Oncology is his primary health care specialty. Herzog, Brett Howard can be contacted via phone (618) 607-1340.

Contact Information

Primary practice address
1418 Cross St Div Im Medical Oncology, Ste 180 Shiloh IL 62269-2914
Phone: (618) 607-1340
Fax: (618) 622-9724
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036153509 Illinois
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 036153509 Illinois

Profile Details

NPI number 1023499282
LBN Legal business name Herzog, Brett Howard
Credentials MD PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2015
Last updated Nov 8th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023499282 NPPES
Missouri MEDICAID 200063716

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