Provider Demographics
NPI:1124028360
Name:PAYNE, JOHN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:PAYNE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:950 N YORK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-2950
Mailing Address - Country:US
Mailing Address - Phone:630-325-4255
Mailing Address - Fax:630-325-2147
Practice Address - Street 1:950 N YORK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2950
Practice Address - Country:US
Practice Address - Phone:630-325-4255
Practice Address - Fax:630-325-2147
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D12652Medicare UPIN
IL474040Medicare ID - Type Unspecified