Individual
KENNETH J SCHWEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
209 NW 11TH ST, FAIRFIELD, IL 62837-1218
(618) 842-4470
(618) 842-3437
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-2401
(618) 724-4628
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000186
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970029172
RAILROAD MEDICARE
IL
Enumeration date
06/28/2005
Last updated
06/19/2012
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