Provider Demographics
NPI:1740361112
Name:HERING, PAUL J (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:HERING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:LOYOLA UNIVERSITY MEDICAL CENTER
Mailing Address - Street 2:LUH - NORTH ENT., RM.7604
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153
Mailing Address - Country:US
Mailing Address - Phone:708-216-8757
Mailing Address - Fax:708-216-1259
Practice Address - Street 1:LOYOLA UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:LUH - NORTH ENT., RM.7604
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153
Practice Address - Country:US
Practice Address - Phone:708-216-8757
Practice Address - Fax:708-216-1259
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2009-09-17
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Provider Licenses
StateLicense IDTaxonomies
IL036051861207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D14091Medicare UPIN