Organization
SIEBERT MOAZZAM P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL A SIEBERT MD (OWNER)
(309) 353-1833
Entity
Organization
Contact information
Practice address
401 MAIN STREET, SUITE 1200, PEORIA, IL 61602-1242
(309) 671-8749
Mailing address
2205 STATE ST, PEKIN, IL 61554-3936
(309) 353-1833
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036101798
IL
Other
Enumeration date
06/17/2006
Last updated
04/12/2011
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