| Matthew J Weidman, MD | |
|
2028 N Seminary St, Galesburg, IL 61401 | |
| (309) 647-0201 | |
| Not Available |
| Full Name | Matthew J Weidman |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 2028 N Seminary St, Galesburg, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134226145 | NPI | - | NPPES |
| 036116945 | Medicaid | IL | |
| 09015685 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036116945 (Illinois) | Primary |
| Entity Name | Graham Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780692087 PECOS PAC ID: 2769375021 Enrollment ID: O20040510000873 |
| Entity Name | Osf Healthcare System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679606073 PECOS PAC ID: 4284541806 Enrollment ID: O20070503000249 |
| Entity Name | Osf Multi-specialty Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew J Weidman, MD 1706 W Agency Rd, West Burlington, IA 52655-1667 Ph: (319) 753-5177 | Matthew J Weidman, MD 2028 N Seminary St, Galesburg, IL 61401 Ph: (309) 647-0201 |
Lynn L Greeley, M.C. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3315 N Seminary St, Galesburg, IL 61401 Phone: 309-344-1000 Fax: 309-344-1054 | |
Amy S Larson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 834 N Seminary St, Suite 304, Galesburg, IL 61401 Phone: 309-342-2144 Fax: 309-342-5104 | |
B. S. Kesavan, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 834 N Seminary St, Suite 302, Galesburg, IL 61401 Phone: 309-342-2171 Fax: 309-342-7205 | |
Subash Paralikar, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 834 N Seminary St, 304, Galesburg, IL 61401 Phone: 309-342-2144 Fax: 309-342-5104 | |
Frank Peppers, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 834 N Seminary St, Suite 302, Galesburg, IL 61401 Phone: 309-342-2171 |