Provider Demographics
NPI:1326096553
Name:WESSELMANN, CURT A (DC)
Entity Type:Individual
Prefix:
First Name:CURT
Middle Name:A
Last Name:WESSELMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:IL
Mailing Address - Zip Code:62293-1110
Mailing Address - Country:US
Mailing Address - Phone:618-224-9118
Mailing Address - Fax:618-224-2129
Practice Address - Street 1:206 W BROADWAY
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:IL
Practice Address - Zip Code:62293-1110
Practice Address - Country:US
Practice Address - Phone:618-224-9118
Practice Address - Fax:618-224-2129
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007329111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038007329Medicaid
IL038007329Medicaid
IL214314Medicare PIN