Individual provider Active NPI

John Herrmann Mueller, MD

  • Family Medicine Physician
  • Loves Park, IL
National Provider Identifier
1952335333
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036081083 Issued in IL
Practice address
9951 Rock Cut Xing
Loves Park, IL 61111-1999
Phone
(815) 639-8500
Fax
(815) 639-8501
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036081083 IL Primary

Addresses

Primary practice location

9951 Rock Cut Xing
Loves Park, IL 61111-1999

Mailing address

9951 Rock Cut Xing
Loves Park, IL 61111-1999
Phone (815) 639-8500

Other identifiers 3

IdentifierTypeStateIssuer
036081083MedicaidIL
553180OtherILMEDICARE GROUP #
834370OtherILMEDICARE GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036081083ILMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1952335333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9951 ROCK CUT XING",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611111999",
            "telephone_number": "815-639-8500",
            "fax_number": "815-639-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9951 ROCK CUT XING",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611111999",
            "telephone_number": "815-639-8500",
            "fax_number": "815-639-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "JOHN",
        "middle_name": "HERRMANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036081083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081083",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "553180",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "834370",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.