Individual
ANGELA D WUEBBELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
12 WOLF CREEK DR, STE 200, SWANSEA, IL 62226-2343
(618) 239-9910
(618) 239-9795
Mailing address
916 TALON DR, STE 102, O FALLON, IL 62269-1848
(618) 628-8211
(618) 628-0883
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08220357
BCBS GRP#
IL
01
—
7894268
AETNA
IL
01
—
P00110675
MEDICARE RAILROAD
IL
Enumeration date
06/22/2005
Last updated
01/08/2008
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