Provider Demographics
NPI:1568484590
Name:FEINERMAN, ADRIAN DOUGLAS (MD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:DOUGLAS
Last Name:FEINERMAN
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 1:501 W. ILLINOIS ST.
Mailing Address - Street 2:
Mailing Address - City:STEELEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62288
Mailing Address - Country:US
Mailing Address - Phone:618-965-9266
Mailing Address - Fax:618-965-9508
Practice Address - Street 1:501 W ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:STEELEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62288-1322
Practice Address - Country:US
Practice Address - Phone:618-965-9266
Practice Address - Fax:618-965-9508
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2286273OtherFIRST HEALTH
IL105069OtherHEALTH ALLIANCE
IL7932009OtherBCBS
IL105069OtherHEALTH ALLIANCE
IL211031Medicare ID - Type Unspecified