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Contact Information

JUAN C HERNANDEZ, MD
102 S HENNEPIN AVE
DIXON, IL61021
 Phone: 815-288-7711
 Fax: 815-285-8922
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JUAN C HERNANDEZ · (Male)

NPI Number 1780650176
Status Active
Credentials MD
Entity Individual
Enumeration date 02/24/2006
Last updated 08/22/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036-112949
  • IL Medicaid 036112949
  • IL Other 800200003 MEDICARE-KATHERINE SHAW BETHEA HOSPITAL
  • IL Other K16904 MEDICARE-KSB MEDICAL GROUP
Hospital affiliation(s)
  • CGH MEDICAL CENTER - (Acute Care)
    100 EAST LEFEVRE ROAD
    STERLING, IL 61081
  • KATHERINE SHAW BETHEA HOSPITAL - (Acute Care)
    403 E 1ST ST
    DIXON, IL 61021
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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