Provider Demographics
NPI:1144202904
Name:WEISSMAN, SCOTT M (MS, CGC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:M
Last Name:WEISSMAN
Suffix:
Gender:M
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CENTRAL STREET
Mailing Address - Street 2:SUITE 620
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201
Mailing Address - Country:US
Mailing Address - Phone:847-570-1015
Mailing Address - Fax:847-733-5318
Practice Address - Street 1:1000 CENTRAL ST
Practice Address - Street 2:SUITE 620
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1777
Practice Address - Country:US
Practice Address - Phone:847-570-1015
Practice Address - Fax:847-733-5318
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS