Individual
MATTHEW J WEIDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2028 N SEMINARY ST, GALESBURG, IL 61401
(309) 647-0201
Mailing address
1706 W AGENCY RD, WEST BURLINGTON, IA 52655-1667
(319) 753-5177
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036116945
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116945
—
IL
01
—
09015685
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/20/2006
Last updated
08/27/2024
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