Provider Demographics
NPI:1700973351
Name:SIMMERING, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:SIMMERING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6812 STATE ROUTE 162
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-8553
Mailing Address - Country:US
Mailing Address - Phone:618-288-1122
Mailing Address - Fax:618-288-1144
Practice Address - Street 1:6812 STATE ROUTE 162
Practice Address - Street 2:SUITE 120
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-8553
Practice Address - Country:US
Practice Address - Phone:618-288-1122
Practice Address - Fax:618-288-1144
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2013-01-16
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Provider Licenses
StateLicense IDTaxonomies
IL036067473207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036067473Medicaid
IL08232205OtherBLUE CROSS BLUE SHIELD
E85167Medicare UPIN
ILK31928Medicare PIN
IL036067473Medicaid