Organization
FAMILY PHYSICIANS OF MADISON COUNTY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND K WEBER M.D. (PRESIDENT)
(618) 288-5088
Entity
Organization
Contact information
Practice address
3 JUNCTION DR W, GLEN CARBON, IL 62034-2916
(618) 288-5088
Mailing address
3 JUNCTION DR W, GLEN CARBON, IL 62034-2916
(618) 288-5088
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080021119
RAIL ROAD MEDICARE
IL
01
—
6015373
BLUE SHIELD
IL
Enumeration date
06/24/2005
Last updated
07/21/2022
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