Healthcare Provider Details

I. General information

NPI: 1124014329
Provider Name (Legal Business Name): FERDINAND J. MUELLER, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 S 3RD ST SUITE 200
BELLEVILLE IL
62220-1952
US

IV. Provider business mailing address

180 S 3RD ST SUITE 200
BELLEVILLE IL
62220-1952
US

V. Phone/Fax

Practice location:
  • Phone: 618-233-0017
  • Fax: 618-233-0251
Mailing address:
  • Phone: 618-233-0017
  • Fax: 618-233-0251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. STEPHEN V. MUELLER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 618-233-0017