Basic Information
Provider Information
NPI: 1396752952
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAUFFE
FirstName: JAMES
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 W. PARK ST.
Address2: BWPC
City: URBANA
State: IL
PostalCode: 618012500
CountryCode: US
TelephoneNumber: 2173836792
FaxNumber:  
Practice Location
Address1: 1701 W. CURTIS ROAD
Address2: PEDIATRICS
City: CHAMPAIGN
State: IL
PostalCode: 61822
CountryCode: US
TelephoneNumber: 2173656202
FaxNumber: 2173260188
Other Information
ProviderEnumerationDate: 08/03/2006
LastUpdateDate: 02/15/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X036068894ILY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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