Macoupin Family Practice Center, LLP

Organization Active NPI Family Medicine Physician · Gillespie, IL

NPI 1194915074 · NPPES record last updated Apr 20, 2008

Key facts

NPI
1194915074
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
MACOUPIN FAMILY PRACTICE CENTER, LLP
Practice address
715 Broadway St
Gillespie, IL 62033-1166
Phone
(217) 839-4491
Fax
(217) 839-2689
NPI assigned
Jul 27, 2007
Organization subpart
No

Authorized official

Name
Dr. Bruce F Weber, MD
Title
Director
Phone
(217) 839-4491

Corporate family (same tax ID) 6

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Macoupin Family Practice Centers LLP (7 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

715 Broadway St
Gillespie, IL 62033-1166

Mailing address

715 Broadway St
Gillespie, IL 62033-1166
Phone (217) 839-4491

Other names

  • Gillespie Family Practice Ctr Doing business as

Other providers in Gillespie, IL

All providers in Gillespie, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.