Individual
GLENN I WEINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
800 BIESTERFIELD RD, SUITE 4003, ELK GROVE VILLAGE, IL 60007-3668
(847) 364-0800
(847) 364-0854
Mailing address
800 BIESTERFIELD RD, SUITE 4003, ELK GROVE VILLAGE, IL 60007-3361
(847) 364-0800
(847) 364-0854
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
036053094
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053094
—
IL
01
—
21608486
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/29/2007
Last updated
12/21/2021
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