Individual
MARC GORDON WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S FIRST AVE, (FAHEY BLDG., RM. 270), MAYWOOD, IL 60153
(708) 216-5102
(708) 216-1699
Mailing address
2160 S FIRST AVE, (FAHEY BLDG., RM. 270), MAYWOOD, IL 60153
(708) 216-5102
(708) 216-1699
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
36077094
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36077094
—
IL
Enumeration date
02/15/2006
Last updated
06/29/2021
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