Individual
MARK M WESELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
800 ROOSEVELT RD, BLDG B SUITE 112, GLEN ELLYN, IL 60137-5839
(630) 790-3335
(630) 790-3345
Mailing address
800 ROOSEVELT RD, BLDG B SUITE 112, GLEN ELLYN, IL 60137-5839
(630) 790-3335
(630) 790-3345
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038009503
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232331
BCBSIL
IL
Enumeration date
03/16/2006
Last updated
03/25/2013
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