Individual
MR. JOEY ALAN WEGMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
302 BROADWAY ST, MOUNT VERNON, IL 62864-5116
(618) 242-4750
(618) 242-7674
Mailing address
1700 N. HENDERSON, OSF GALESBURG CLINIC PROMPT CARE, GALESBURG, IL 61401
(309) 343-1000
(309) 343-5207
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085000851
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085000851
—
IL
01
—
719926
HEALTHLINK
IL
Enumeration date
08/17/2006
Last updated
02/07/2013
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