Basic Information
| Provider Information | |||||||||
| NPI: | 1386750008 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILDEBRANDT | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | |||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1005 HEALTH CENTER DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | MATTOON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619384693 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2172386055 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1004 HEALTH CENTER DR STE 210 | ||||||||
| Address2: | |||||||||
| City: | MATTOON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619384608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2172384960 | ||||||||
| FaxNumber: | 2172384962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 036082869 | IL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207P00000X | 036-082869 | IL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | 036082869 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.