Provider Demographics
NPI:1053460899
Name:WEILNHAMMER, FRANK X (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:X
Last Name:WEILNHAMMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-9230
Mailing Address - Country:US
Mailing Address - Phone:219-764-5318
Mailing Address - Fax:219-764-3251
Practice Address - Street 1:6050 STERLING CREEK RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-7752
Practice Address - Country:US
Practice Address - Phone:219-763-8112
Practice Address - Fax:219-764-5380
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01066070A207Q00000X
IL036083180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200922900Medicaid
IL036083180Medicaid
IL036083180OtherSTATE LICENSE
IL080038694OtherRAILROAD MEDICARE PTAN
IL036083180Medicaid
ILL20558Medicare PIN