Organization
SIEBERT PODIATRY PC
Active
Other names
Siebert and Sipes Podiatry, PC
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY J SIEBERT (SECRETARY)
(217) 523-4539
Entity
Organization
Contact information
Practice address
102 S GRAND AVE W, SPRINGFIELD, IL 62704-3806
(217) 523-4539
Mailing address
102 S GRAND AVE W, SPRINGFIELD, IL 62704-3806
(217) 523-4539
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
060.001013
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60115587
BCBS
IL
Enumeration date
04/09/2007
Last updated
03/20/2017
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