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Organization
NORTH SHORE PRIMARY CARE S.C.
Active
Organization
NORTH SHORE PRIMARY CARE S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANA WEISS M.D. (PHYSICIAN)
(847) 573-9663
Entity
Organization
Contact information
Practice address
1900 HOLLISTER DR STE 250, LIBERTYVILLE, IL 60048-5249
(847) 573-9663
Mailing address
1900 HOLLISTER DR STE 250, LIBERTYVILLE, IL 60048-5249
(847) 573-9663
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036101407
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101407
—
IL
01
—
04932188
BCBS PROVIDER ID#
IL
01
—
H69159
UPIN
IL
Enumeration date
08/13/2007
Last updated
01/04/2017
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