Provider Demographics
NPI:1841382371
Name:LANGEHENNIG, PATRICIA L (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:L
Last Name:LANGEHENNIG
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2420 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-4315
Mailing Address - Country:US
Mailing Address - Phone:815-722-7000
Mailing Address - Fax:815-722-7180
Practice Address - Street 1:72 N CHICAGO ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-4315
Practice Address - Country:US
Practice Address - Phone:815-722-7000
Practice Address - Fax:815-722-7180
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036053311207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036053311Medicaid
IL09932150OtherBLUE CROSS / BLUE SHIELD
IL036053311Medicaid
ILF79208Medicare UPIN