Provider Demographics
NPI:1518064062
Name:HELFER, ERIC P (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:P
Last Name:HELFER
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 1:101 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3981
Mailing Address - Country:US
Mailing Address - Phone:217-366-1240
Mailing Address - Fax:
Practice Address - Street 1:3101 FIELDS SOUTH DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-3743
Practice Address - Country:US
Practice Address - Phone:217-366-1240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036115465208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00382770OtherRAILROAD MEDICARE
IL279502OtherMEDICARE UROLOGY CLIA GROUP
IL036115465OtherIL STATE LICENSE NUMBER
IL036115445 1Medicaid
ILK35004Medicare PIN
ILI68186Medicare UPIN
IL0407950001Medicare NSC
ILP00382770OtherRAILROAD MEDICARE