Individual
DR. LEE DAVID WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7234 WEST OGDEN AVENUE, SUITE 3N, RIVERSIDE, IL 60546-2387
(708) 447-2277
(708) 447-2274
Mailing address
1341 WARREN AVENUE, DOWNERS GROVE, IL 60515-3437
(630) 719-5454
(630) 719-1263
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036.044369
IL
2084P0800X
Psychiatry Physician
036044369
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036044369
—
IL
01
—
211323007
PTAN
IL
01
—
211324005
PTAN
IL
Enumeration date
03/09/2006
Last updated
05/08/2014
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