| Richard J Siebert, M.d.,s,c. | |
|
700 N Westmoreland Rd Ste B Lake Forest IL 60045-1672 | |
| (847) 234-8808 | |
| Not Available |
| Full Name | Richard J Siebert, M.d.,s,c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 700 N Westmoreland Rd Ste B, Lake Forest, Illinois |
| Authorized Official Name and Position | Richard J Siebert (PRESIDENT) |
| Authorized Official Contact | 8472348808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard J Siebert, M.d.,s,c. 700 N Westmoreland Rd Ste B Lake Forest IL 60045-1672 Ph: (847) 234-8808 | Richard J Siebert, M.d.,s,c. 700 N Westmoreland Rd Ste B Lake Forest IL 60045-1672 Ph: (847) 234-8808 |
| NPI Number | 1003022088 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0941395933 |
|---|---|
| Medicare Enrollment ID | O20071005000357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003022088 | NPI | - | NPPES |
| 4900663 | Other | IL | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Illinois) | Primary |
| Provider Name | Richard J Siebert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205985157 PECOS PAC ID: 8729173760 Enrollment ID: I20071004000806 |
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