Provider Demographics
NPI:1801358502
Name:WELSH, ABBY ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:ELIZABETH
Last Name:WELSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:ESKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1005 HEALTH CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-4653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1303 W EVERGREEN AVE STE 203
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-1638
Practice Address - Country:US
Practice Address - Phone:217-540-6122
Practice Address - Fax:217-347-7197
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN390200000X
IL036-162220208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program