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Organization
RICHARD J SIEBERT, M.D.,S,C.
Active
Organization
RICHARD J SIEBERT, M.D.,S,C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J SIEBERT M.D. (PRESIDENT)
(847) 234-8808
Entity
Organization
Contact information
Practice address
700 N WESTMORELAND RD STE B, LAKE FOREST, IL 60045-1672
(847) 234-8808
Mailing address
700 N WESTMORELAND RD STE B, LAKE FOREST, IL 60045-1672
(847) 234-8808
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4900663
BLUE SHIELD
IL
Enumeration date
05/15/2007
Last updated
08/22/2020
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