Provider Demographics
NPI:1336644228
Name:WEYENBERG, JENNY (DO)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:WEYENBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:BHATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:25 N WINFIELD RD STE 400
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1379
Practice Address - Country:US
Practice Address - Phone:630-456-7178
Practice Address - Fax:630-456-7486
Is Sole Proprietor?:No
Enumeration Date:2018-03-24
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-157092208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist