Provider Demographics
NPI:1679526941
Name:EARMAN, WILLIAM A JR (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:EARMAN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12251 S 80TH AVE STE 1630
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1256
Mailing Address - Country:US
Mailing Address - Phone:708-923-5173
Mailing Address - Fax:708-923-5108
Practice Address - Street 1:6450 W COLLEGE DRIVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1774
Practice Address - Country:US
Practice Address - Phone:708-389-1500
Practice Address - Fax:708-389-3322
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036073708207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036073708Medicaid
IL766283Medicare ID - Type Unspecified
ILD16345Medicare UPIN