Individual
DR. DIANE MARILYN WEIS BONTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 NTH 7TH STREET, STE C, SPRINGFIELD, IL 62702
(217) 522-9730
(217) 522-9761
Mailing address
1314 NORTH STATE STREET, LITCHFIELD, IL 62056-1106
(217) 522-9730
(217) 522-9761
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36104833
IL
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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