Wanless, Robert C.

Wanless, Robert C. is an individual health care provider with primary practice located at 4600 Memorial Dr Suite 320, Belleville IL 62226-5366. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Wanless, Robert C. can be contacted via phone (618) 257-2100.

Contact Information

Primary practice address
4600 Memorial Dr Suite 320 Belleville IL 62226-5366
Phone: (618) 257-2100
Fax: (618) 257-2169
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 036 - 052657 Illinois

Profile Details

NPI number 1548258288
LBN Legal business name Wanless, Robert C.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Mar 20th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548258288 NPPES
Illinois MEDICAID 036052657

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