Weiss, Everett Lawrence
Weiss, Everett Lawrence is an sole proprietor health care provider with primary practice located at 820 E Terra Cotta Ave Suite 226, Crystal Lake IL 60014-3649. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Weiss, Everett Lawrence can be contacted via phone (815) 455-2100.Contact Information
Primary practice address
820 E Terra Cotta Ave Suite 226
Crystal Lake IL 60014-3649
Phone: (815) 455-2100
Fax: (425) 988-1002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036117699 | Illinois |
Profile Details
| NPI number | 1700909728 |
|---|---|
| LBN Legal business name | Weiss, Everett Lawrence |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 6th, 2007 |
| Last updated | Apr 23rd, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700909728 | NPPES |
| Illinois | MEDICAID | 036117699 |
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