Provider Demographics
NPI:1952521791
Name:WOERNER, PHILIP I (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:I
Last Name:WOERNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:238 HEATHERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62629-8697
Mailing Address - Country:US
Mailing Address - Phone:217-546-3717
Mailing Address - Fax:217-773-2425
Practice Address - Street 1:700 SE CROSS
Practice Address - Street 2:MENTAL HEALTH CENTERS OF WESTERN ILLINOIS
Practice Address - City:MT STERLING
Practice Address - State:IL
Practice Address - Zip Code:62353
Practice Address - Country:US
Practice Address - Phone:217-773-3325
Practice Address - Fax:217-773-2425
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2019-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0360414852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036041485OtherMEDICAL LICENSE
IL336009909OtherCONT SUBSTANCE