Search › Illinois › 207PE0004X
Matthew Oldenburg
NPI 1164272142 · on the registry since 2024 · sole proprietor
Practice
- Address
- 14880 Old Colonial Rd
Bloomington, IL 61705 - Phone
- (309) 828-4641
- Organisation at this address
- Bloomington Township Fire Protection District
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 207PE0004X
207PE0004X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-03-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois