Weaver, Barry Craig

Weaver, Barry Craig is an individual health care provider with primary practice located at 306 Saint Joseph Dr , Bloomington IL 61701-3506. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Weaver, Barry Craig can be contacted via phone (309) 663-2354.

Contact Information

Primary practice address
306 Saint Joseph Dr Bloomington IL 61701-3506
Phone: (309) 663-2354
Fax: (309) 662-8602
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036078523 Illinois

Profile Details

NPI number 1609824242
LBN Legal business name Weaver, Barry Craig
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Jul 29th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609824242 NPPES
Illinois MEDICAID 036078523

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