Basic Information
| Provider Information | |||||||||
| NPI: | 1518450097 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HART | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | DANIEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 19679 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 627949679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2175453518 | ||||||||
| FaxNumber: | 2175452711 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 N 1ST ST STE D220 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 627023757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2175453518 | ||||||||
| FaxNumber: | 2175452711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2018 | ||||||||
| LastUpdateDate: | 09/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD-48623 | IA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PE0004X | MD-48623 | IA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207P00000X | 125072354 | IL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.