Organization
TERRIE L WEIR MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRIE L WEIR MD (PRESIDENT)
(708) 366-7177
Entity
Organization
Contact information
Practice address
7605 1/2 NORTH AVE, RIVER FOREST, IL 60305-1133
(708) 366-4888
Mailing address
7605 1/2 NORTH AVE, RIVER FOREST, IL 60305-1133
(708) 366-4888
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036081633
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635987
BCBS IL
IL
05
—
036081633
—
IL
Enumeration date
08/16/2007
Last updated
08/16/2007
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