Individual
JAMES E WACHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1006 S DIVISION ST, CARTERVILLE, IL 62918-1539
(618) 985-4841
(618) 985-8101
Mailing address
PO BOX 577, CARTERVILLE, IL 62918-0577
(618) 985-8221
(618) 985-6860
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036076399
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036076399
—
IL
05
—
370966854004
—
IL
01
—
CF3444
MEDICARE RAILROAD GROUP
IL
Enumeration date
05/15/2006
Last updated
01/11/2010
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