# WEBER MEDICAL CLINIC LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093810350
- **Authorized official:** MR. JOHN L REED (ADMINISTRATOR)
- **Authorized official phone:** (618) 395-2223

## Contact information

- **Practice address:** 1200 N EAST ST, OLNEY, IL 62450-2499
- **Practice address phone:** (618) 395-5222
- **Practice address fax:** (618) 395-8552
- **Mailing address:** 1200 N EAST ST, WEBER MEDICAL CLINIC LTD, OLNEY, IL 62450-2499
- **Mailing address phone:** (618) 395-5222
- **Mailing address fax:** (618) 395-8552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 03/25/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 08015410 | BLUE CROSS BLUE SHIELD | IL |
| 01 | — | CL4973 | RAILROAD MEDICARE | — |