Provider Demographics
NPI:1487627170
Name:LANGNER, HERMAN PAUL (MD)
Entity Type:Individual
Prefix:MR
First Name:HERMAN
Middle Name:PAUL
Last Name:LANGNER
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 1:502 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1839
Mailing Address - Country:US
Mailing Address - Phone:630-377-7225
Mailing Address - Fax:630-584-0808
Practice Address - Street 1:502 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1839
Practice Address - Country:US
Practice Address - Phone:630-377-7225
Practice Address - Fax:630-584-0808
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-11
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0423052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL39532Medicare UPIN
IL313150Medicare ID - Type Unspecified