# SIEBERT MOAZZAM P C

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1396780292
- **Authorized official:** PAUL A SIEBERT MD (OWNER)
- **Authorized official phone:** (309) 353-1833

## Contact information

- **Practice address:** 401 MAIN STREET, SUITE 1200, PEORIA, IL 61602-1242
- **Practice address phone:** (309) 671-8749
- **Mailing address:** 2205 STATE ST, PEKIN, IL 61554-3936
- **Mailing address phone:** (309) 353-1833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 036101798 | IL | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 04/12/2011