Individual
DIANE WEIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, R/L
Contact information
Practice address
950 LEE ST, DES PLAINES, IL 60016-6532
(877) 486-4140
Mailing address
950 LEE ST, DES PLAINES, IL 60016-6532
(877) 486-4140
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.010914
IL
225X00000X
Occupational Therapist
Primary
056010914
IL
Other
Enumeration date
01/19/2015
Last updated
05/13/2024
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