Individual
RONALD D. WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
503 E GRANT ST, MACOMB, IL 61455-3313
(309) 833-5917
Mailing address
503 E GRANT ST, MACOMB, IL 61455-3313
(309) 833-5917
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036113540
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036-113540
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113540
—
IL
01
—
110510
HEALTH ALLIANCE
—
Enumeration date
08/02/2006
Last updated
02/12/2015
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