Individual
DR. ELAINE WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2200 FORT JESSE RD STE 110, NORMAL, IL 61761-6286
(309) 661-6290
(309) 451-1354
Mailing address
2200 FORT JESSE RD STE 110, NORMAL, IL 61761-6286
(309) 661-6290
(309) 451-1354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MT-191048
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833120
MEDICARE GROUP #
—
Enumeration date
07/11/2007
Last updated
10/19/2010
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