Provider Demographics
NPI:1568417780
Name:FIMMEL, CLAUS J (MD)
Entity Type:Individual
Prefix:
First Name:CLAUS
Middle Name:J
Last Name:FIMMEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:BURCH BUILDLING, ROOM 103 A
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-1762
Mailing Address - Fax:847-733-5310
Practice Address - Street 1:2160 S FIRST AVE
Practice Address - Street 2:(15750 MARION DRIVE, HOMER GLEN, IL. 60491)
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153
Practice Address - Country:US
Practice Address - Phone:708-645-3400
Practice Address - Fax:708-645-3411
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-08-30
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Provider Licenses
StateLicense IDTaxonomies
IL036115700207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E48505Medicare UPIN