Weiss, Lori J

Weiss, Lori J is an individual health care provider with primary practice located at 6840 Windsor Ave , Berwyn IL 60402-3441. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Weiss, Lori J can be contacted via phone (708) 484-0042.

Contact Information

Primary practice address
6840 Windsor Ave Berwyn IL 60402-3441
Phone: (708) 484-0042
Fax: (708) 749-5489
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 036074273 Illinois

Profile Details

NPI number 1053314484
LBN Legal business name Weiss, Lori J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Feb 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053314484 NPPES
Illinois MEDICAID 036074273

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