Provider Demographics
NPI:1528048410
Name:BOWMAN, JOHN LANDIS (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LANDIS
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:802 SUNNYMEADE TRAIL
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-2350
Mailing Address - Country:US
Mailing Address - Phone:815-756-8421
Mailing Address - Fax:
Practice Address - Street 1:HEALTH SERVICES
Practice Address - Street 2:NORTHERN ILLINOIS UNIVERSITY
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2854
Practice Address - Country:US
Practice Address - Phone:815-753-1311
Practice Address - Fax:815-753-9599
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice