Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 036123979 | IL |
Y | 208600000X | Surgeon | 036123979 | IL |
N | 2082S0105X | Plastic Hand Surgeon | 036123979 | IL |
NPI | 1861434805 |
---|---|
Provider Name | Dr. Jeffrey Weinzweig |
First Address | Chicago, IL 60611-2218 |
Second Address | Chicago, IL 60611-2218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 15/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0131750 | (05) | MA |
E41840 | (02) | MA |