Glen a Weisgerber MD SC
Organization Active NPI Family Medicine Physician · Auburn, IL
NPI 1124337605 · NPPES record last updated Sep 30, 2010
Key facts
- NPI
- 1124337605
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- GLEN A WEISGERBER MD SC
- Practice address
- 100 S 5TH St
Auburn, IL 62615-1402 - Phone
- (217) 438-6175
- NPI assigned
- Sep 30, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Glen Weisgerber
- Title
- Owner
- Phone
- (217) 438-6175
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0435318 | Glen a Weisgerber MD | Certificate of waiver | Jul 12, 2026 |
National Provider Directory
Locations
100 S 5th St
Auburn, IL 62615
Phone (217) 438-6175
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
100 S 5TH St
Auburn, IL 62615-1402
Mailing address
100 S 5TH St
Auburn, IL 62615-1402
Other providers in Auburn, IL
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- Kathryn A Fry
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All providers in Auburn, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.