Individual
MATTHEW OLDENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14880 OLD COLONIAL RD, BLOOMINGTON, IL 61705-5981
(309) 828-4641
Mailing address
15817 OLD ORCHARD RD, BLOOMINGTON, IL 61705-5524
(309) 287-9157
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
001082825
IL
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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