Provider Demographics
NPI:1376650135
Name:RIERMAIER, MICHAEL JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:RIERMAIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 N RANDALL RD STE 304
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-2304
Mailing Address - Country:US
Mailing Address - Phone:847-697-7722
Mailing Address - Fax:847-697-7896
Practice Address - Street 1:1435 N RANDALL RD STE 304
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2304
Practice Address - Country:US
Practice Address - Phone:847-697-7722
Practice Address - Fax:847-697-7896
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363816770207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036065268Medicaid
IL036065268Medicaid
IL201498Medicare ID - Type Unspecified