Individual
DR. THOMAS D WEYBURN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
525 E CONGRESS PKWY STE 300, CRYSTAL LAKE, IL 60014-6258
(815) 759-9260
(815) 459-7840
Mailing address
1800 HOLLISTER DR, SUITE 112, LIBERTYVILLE, IL 60048-5263
(847) 367-6781
(847) 367-7384
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
036098952
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360989521
—
IL
Enumeration date
11/16/2005
Last updated
08/02/2023
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