Wesemann, Kenneth

Wesemann, Kenneth is an individual health care provider with primary practice located at 88 S Main St Ste 2 , Glen Carbon IL 62034-1415. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Wesemann, Kenneth can be contacted via phone (618) 288-8085.

Contact Information

Primary practice address
88 S Main St Ste 2 Glen Carbon IL 62034-1415
Phone: (618) 288-8085
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 178.013582 Illinois

Profile Details

NPI number 1750852091
LBN Legal business name Wesemann, Kenneth
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2018
Last updated Jun 11th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750852091 NPPES
Illinois Other 178.013582 STATE LICENSE

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