Provider Demographics
NPI:1124014329
Name:FERDINAND J. MUELLER, LTD.
Entity Type:Organization
Organization Name:FERDINAND J. MUELLER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-233-0017
Mailing Address - Street 1:180 S 3RD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-1952
Mailing Address - Country:US
Mailing Address - Phone:618-233-0017
Mailing Address - Fax:618-233-0251
Practice Address - Street 1:180 S 3RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1952
Practice Address - Country:US
Practice Address - Phone:618-233-0017
Practice Address - Fax:618-233-0251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO130304OtherBLUE ADVANTAGE
MO2444V9469OtherGROUP HEALTH PLAN
IL231290OtherMEDICARE GROUP
MO105592OtherBLUE ADVANTAGE
MO111843OtherBLUE ADVANTAGE
IL8215125OtherBC/BS
MO105469OtherBLUE ADVANTAGE
MO2113V9469OtherGROUP HEALTH PLAN