Individual
ETHAN NATHANIEL WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S., M.S.
Contact information
Practice address
405 CENTRAL AVE, NORTHFIELD, IL 60093-3006
(847) 441-5600
Mailing address
405 CENTRAL AVE, NORTHFIELD, IL 60093-3006
(847) 441-5600
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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