1891749198 NPI number — ERIKA L SWITZER HUNTER MD

Table of content: ERIKA L SWITZER HUNTER MD (NPI 1891749198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891749198 NPI number — ERIKA L SWITZER HUNTER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWITZER HUNTER
Provider First Name:
ERIKA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891749198
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 530
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAVANA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62644-0530
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
309-543-6600
Provider Business Mailing Address Fax Number:
309-543-2089

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 S EAST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANITO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61546-8909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
309-968-5311
Provider Business Practice Location Address Fax Number:
309-968-5322
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  036103186 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 036103186 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 09015685 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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