Individual
MS. A. CHARLOTTA WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
259 E ERIE ST, SUITE 475, CHICAGO, IL 60611-2930
(312) 926-5893
Mailing address
259 E ERIE ST, SUITE 475, CHICAGO, IL 60611-2930
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036119655
IL
Other
Enumeration date
01/31/2008
Last updated
10/18/2008
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