Organization
LYDIA S Q VILLAFUERTE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA VILLAFUERTE MD (OWNER)
(217) 854-6262
Entity
Organization
Contact information
Practice address
205 OAKLAND AVE, CARLINVILLE, IL 62626-1921
(217) 854-6262
(217) 854-6264
Mailing address
PO BOX 265, CARLINVILLE, IL 62626-0265
(217) 854-6262
(217) 854-6264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/04/2007
Last updated
08/22/2020
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