Wellman, Richard W

Wellman, Richard W is an sole proprietor health care provider with primary practice located at 1505 Eastland Dr Ste 100 , Bloomington IL 61701-7906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Wellman, Richard W can be contacted via phone (309) 663-8888.

Contact Information

Primary practice address
1505 Eastland Dr Ste 100 Bloomington IL 61701-7906
Phone: (309) 663-8888
Fax: (309) 277-2359
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036091292 Illinois

Profile Details

NPI number 1184629701
LBN Legal business name Wellman, Richard W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 20th, 2005
Last updated Sep 26th, 2019 - about 7 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 1184629701 NPPES
Illinois MEDICAID 036091292

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