Provider Demographics
NPI:1710984158
Name:TEMMERMAN, JOAN CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:CHRISTINE
Last Name:TEMMERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROCK ISLAND ARSENAL BLDG 110
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61299-7240
Mailing Address - Country:US
Mailing Address - Phone:309-782-0805
Mailing Address - Fax:309-782-0910
Practice Address - Street 1:1 ROCK ISLAND ARSENAL BLDG 110
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61299-7240
Practice Address - Country:US
Practice Address - Phone:309-782-0805
Practice Address - Fax:309-782-0910
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.094732207Q00000X
IN01064120A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200872300Medicaid
KYH15505Medicare UPIN
KY64338361Medicaid
IN940280IMedicare PIN
IN000000526931OtherANTHEM PIN