Dr Susan Weller, DMD is a 
Dentist based in Jackson, Illinois. Dr Susan Weller is licensed to practice in Illinois (license number 01918328) and her current practice location is 
1614 West Lafayette Avenue, Jackson, Illinois. She can be reached at her office (for appointments etc.) via phone at 
(217) 243-1114.
NPI number for Dr Susan Weller is 1740350529 and her current mailing address is 1614 West Lafayette Avenue, Jackson, Illinois. She 
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1740350529.
				
				
				
				
				
		 
		
		 
Healthcare Provider's Profile
		
			
			
			| Full Name | Dr Susan Weller | 
|---|
| Gender | Female | 
|---|
| Speciality | Dentist | 
|---|
| Location | 1614 West Lafayette Avenue, Jackson, Illinois | 
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. | 
			
			 
			
						  NPI Data:
			
			- NPI Number: 1740350529
 - Provider Enumeration Date: 11/08/2006
 - Last Update Date: 07/08/2007
 			
			
			 
		 
		 
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 
NOT enrolled with medicare and thus cannot 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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