Individual
DR. EVERETT LAWRENCE WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
820 E TERRA COTTA AVE, SUITE 226, CRYSTAL LAKE, IL 60014-3649
(815) 455-2100
(425) 988-1002
Mailing address
455 W FAIRVIEW CIR, PALATINE, IL 60067-7901
(847) 496-7934
(425) 988-1002
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036117699
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117699
—
IL
Enumeration date
04/06/2007
Last updated
04/23/2012
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