Organization
JEFFREY A. WELLER, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A. WELLER DDS (PRESIDENT)
(312) 654-0606
Entity
Organization
Contact information
Practice address
1050 N STATE ST, MEZZANINE LEVEL, CHICAGO, IL 60610-7829
(312) 654-0606
(312) 654-1606
Mailing address
1050 N STATE ST, MEZZANINE LEVEL, CHICAGO, IL 60610-7829
(312) 654-0606
(312) 654-1606
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19020147
IL
Other
Enumeration date
12/20/2006
Last updated
08/22/2020
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