Provider Demographics
NPI:1184731267
Name:WORKMAN, MICHAEL AARON (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:AARON
Last Name:WORKMAN
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:PO BOX 3988
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62902-3988
Mailing Address - Country:US
Mailing Address - Phone:618-457-5200
Mailing Address - Fax:
Practice Address - Street 1:405 RUSHING DRIVE
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948
Practice Address - Country:US
Practice Address - Phone:618-993-3300
Practice Address - Fax:618-993-0262
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036109719207Q00000X, 208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036109719Medicaid
657869OtherHEALTHLINK
094621OtherHEALTH ALLIANCE
P00166778OtherRAILROAD MEDICARE
10019630OtherBLUE CROSS/BLUE SHIELD
10019630OtherBLUE CROSS/BLUE SHIELD
IL036109719Medicaid
IL214881Medicare Oscar/Certification