Earl Ernst Woeltje Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019019646 Issued in IL

Practice address

712 N Bloomington St
P.O. 516
Streator, IL 61364-2087

Phone

(815) 672-2195

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Earl E Woeltje Jr

  • Dentist
  • Streator, IL
  • NPI 1437664976
  NPD Authorized official
• Herwig Chiropractic LTD

  • Chiropractor
  • Streator, IL
  • NPI 1548363088
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1235347279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N BLOOMINGTON ST",
            "address_2": "P.O. 516",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642087",
            "telephone_number": "815-672-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N BLOOMINGTON ST",
            "address_2": "P.O. 516",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642087",
            "telephone_number": "815-672-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOELTJE",
        "first_name": "EARL",
        "middle_name": "ERNST",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019019646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trent Ryan Weeks, PHARMD
• Western Illinois ENT and Allergy
• Gary B. White, O.D.
• Sheri Wilkinson
• Leon Wise, M.D.
• Dana Beth Yednock, DNP, WHNP-BC, APRN
• Youth Service Bureau of Illinios Valley
• Brittany Zook

• Dentist in Streator, IL
• Providers in Streator, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.