Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 036.138147 | IL |
Y | 2081S0010X | Sports Medicine | 036.138147 | IL |
Y | 213ES0000X | Sports Medicine | 036.138147 | IL |
NPI | 1467772376 |
---|---|
Provider Name | Dr. Nicholas Hjort Weber |
First Address | Chicago, IL 60657-7227 |
Second Address | Chicago, IL 60657-7227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2010 |
Last Update Date | 11/02/2020 |