Phoenix, James W

Phoenix, James W is an individual health care provider with primary practice located at 1747 Henry Luckow Ln , Belvidere IL 61008-1702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Phoenix, James W can be contacted via phone (815) 971-3030.

Contact Information

Primary practice address
1747 Henry Luckow Ln Belvidere IL 61008-1702
Phone: (815) 971-3030
Fax: (815) 971-9895
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036059274 Illinois

Profile Details

NPI number 1700922267
LBN Legal business name Phoenix, James W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated Jun 18th, 2015 - about 9 years ago

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1700922267 NPPES
Illinois Other F400205679 MEDICARE PTAN
Illinois MEDICAID 036059274 MEDICARE PTAN

Popular Providers