Weiss, Marc Gordon

Weiss, Marc Gordon is an individual health care provider with primary practice located at 2160 S First Ave (Fahey Bldg., Rm. 270), Maywood IL 60153. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Weiss, Marc Gordon can be contacted via phone (708) 216-5102.

Contact Information

Primary practice address
2160 S First Ave (Fahey Bldg., Rm. 270) Maywood IL 60153
Phone: (708) 216-5102
Fax: (708) 216-1699
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 36077094 Illinois

Profile Details

NPI number 1881668713
LBN Legal business name Weiss, Marc Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Jun 29th, 2021 - about 3 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 1881668713 NPPES
Illinois MEDICAID 36077094

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