Paul A Siebert
Cardiothoracic Vascular Surgeon
1001 Main St Suite 300
Peoria
, Illinois 61606-1907
Paul A Siebert
Cardiothoracic Vascular Surgeon
1001 Main St Suite 300
Peoria
, Illinois 61606-1907
(309) 353-0472
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About
Features
Specialties
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Paul A Siebert
- 600 S 13th St Ste M
- Pekin, IL
- Zip : 61554-4936
- Fax : (309) 353-0472
- Phone : (309) 353-0765
Second Address
- Paul A Siebert
- 1001 Main St Suite 300
- Peoria, IL
- Zip : 61606-1907
- Fax : (309) 353-4380
- Phone : (309) 495-0200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | 036090618 | IL |
National Provider Identifier
| NPI | 1154337236 |
|---|---|
| Provider Name | Paul A Siebert |
| First Address | Pekin, IL 61554-4936 |
| Second Address | Peoria, IL 61606-1907 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/07/2006 |
| Last Update Date | 06/02/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036090618 | (05) | IL |
| G13632 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.