Provider Demographics
NPI:1417908906
Name:CIHAK, DEBBIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:ANN
Last Name:CIHAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:IL
Mailing Address - Zip Code:61036-8118
Mailing Address - Country:US
Mailing Address - Phone:815-776-7381
Mailing Address - Fax:815-776-7385
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:IL
Practice Address - Zip Code:61036-8118
Practice Address - Country:US
Practice Address - Phone:815-776-7381
Practice Address - Fax:815-776-7385
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27986207R00000X
IL036-081764207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0094946Medicaid
E64454Medicare UPIN