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Organization
WEBER MEDICAL CLINIC LTD
Active
Organization
WEBER MEDICAL CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN L REED (ADMINISTRATOR)
(618) 395-2223
Entity
Organization
Contact information
Practice address
1200 N EAST ST, OLNEY, IL 62450-2499
(618) 395-5222
(618) 395-8552
Mailing address
1200 N EAST ST, WEBER MEDICAL CLINIC LTD, OLNEY, IL 62450-2499
(618) 395-5222
(618) 395-8552
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08015410
BLUE CROSS BLUE SHIELD
IL
01
—
CL4973
RAILROAD MEDICARE
—
Enumeration date
09/13/2006
Last updated
03/25/2009
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