Organization
PRAIRIE BLEEDING AND CLOTTING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSVALDO H WESLY M.D. (MEDICAL DIRECTOR)
(217) 414-1041
Entity
Organization
Contact information
Practice address
105 S AMOS AVE, SPRINGFIELD, IL 62704-1528
(217) 546-7100
(217) 546-7111
Mailing address
105 S AMOS AVE, SPRINGFIELD, IL 62704-1528
(217) 546-7100
(217) 546-7111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036.089289
IL
Other
Enumeration date
05/11/2016
Last updated
04/07/2025
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