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Individual

ANGELA WEIDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
109 E MAPLE ST, GILLESPIE, IL 62033-1473
(217) 839-4190
(217) 839-1538
Mailing address
109 E MAPLE ST, GILLESPIE, IL 62033-1473
(217) 839-4190
(217) 839-1538

Taxonomy

Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
041.389054
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
376001351007
IL
Enumeration date
07/28/2015
Last updated
04/26/2026
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