Provider Demographics
NPI:1275820763
Name:WEILER, CHRISTINE M (MA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:WEILER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9855 WOODS DR
Mailing Address - Street 2:STE. G105
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1074
Mailing Address - Country:US
Mailing Address - Phone:847-966-9343
Mailing Address - Fax:
Practice Address - Street 1:9855 WOODS DR
Practice Address - Street 2:STE. G105
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1074
Practice Address - Country:US
Practice Address - Phone:847-966-9343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006242101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional