Individual
DR. DANIEL RALPH WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1055 MCHENRY RD, WHEELING, IL 60090-2231
(847) 215-2583
(847) 215-2584
Mailing address
7012 W BIRCHWOOD AVE, NILES, IL 60714-3716
(847) 647-9490
(484) 303-9252
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-008142
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016-84635
BC-BS OF ILLINOIS
IL
Enumeration date
04/17/2007
Last updated
04/08/2010
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