Basic Information
| Provider Information | |||||||||
| NPI: | 1194919522 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WILLIAM ZIMMER MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 E CARPENTER ST | ||||||||
| Address2: | PO BOX 1977 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 627025323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2175446464 | ||||||||
| FaxNumber: | 2177576021 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 N 8TH ST | ||||||||
| Address2: | SUITE 1 B201 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 627011041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2175353799 | ||||||||
| FaxNumber: | 2175255685 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2007 | ||||||||
| LastUpdateDate: | 10/02/2007 | ||||||||
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| AuthorizedOfficialLastName: | ZIMMER | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2175446464 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.