Lori J Weiss
Adolescent Medicine
6840 Windsor Ave
Berwyn
, Illinois 60402-3441
Lori J Weiss
Adolescent Medicine
6840 Windsor Ave
Berwyn
, Illinois 60402-3441
(708) 749-5489
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Lori J Weiss
- 6840 Windsor Ave
- Berwyn, IL
- Zip : 60402-3441
- Fax : (708) 749-5489
- Phone : (708) 484-0042
Second Address
- Lori J Weiss
- 6840 Windsor Ave
- Berwyn, IL
- Zip : 60402-3441
- Fax : (708) 749-5489
- Phone : (708) 484-0042
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 036074273 | IL |
National Provider Identifier
| NPI | 1053314484 |
|---|---|
| Provider Name | Lori J Weiss |
| First Address | Berwyn, IL 60402-3441 |
| Second Address | Berwyn, IL 60402-3441 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/05/2005 |
| Last Update Date | 14/02/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036074273 | (05) | IL |
| H48176 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.