Individual
KATHLEEN WEIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3903 INDIANAPOLIS BLVD, EAST CHICAGO, IN 46312-2555
(219) 769-4005
Mailing address
123 S GREEN ST APT 1207B, CHICAGO, IL 60607-3660
(585) 507-5669
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
71009624A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71009624A
LICENSE
IN
Enumeration date
12/20/2019
Last updated
12/20/2019
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