Dr Susan Weller, DMD is a medicare enrolled "Dentist" provider in Jackson, Illinois. Her current practice location is
1614 West Lafayette Avenue, Jackson, Illinois. You can reach out to her office (for appointments etc.) via phone at
(217) 243-1114.
Dr Susan Weller is licensed to practice in Illinois (license number 01918328) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1740350529.
Healthcare Provider's Profile
Full Name | Dr Susan Weller |
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Gender | Female |
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Speciality | Dentist |
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Location | 1614 West Lafayette Avenue, Jackson, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1740350529
- Provider Enumeration Date: 11/08/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 5496072910
- Enrollment ID: I20150323000275
Medical Identifiers
Medical identifiers for Dr Susan Weller such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1740350529 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 01918328 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Susan Weller is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Susan Weller, DMD 1614 West Lafayette Avenue, Jackson, IL 62650 Ph: (217) 243-1114 | Dr Susan Weller, DMD 1614 West Lafayette Avenue, Jackson, IL 62650 Ph: (217) 243-1114 |
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