Provider Demographics
NPI:1366676090
Name:WEINSTEIN, BRIAN JOEL (NP)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:JOEL
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:8019 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8019 RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3408
Practice Address - Country:US
Practice Address - Phone:224-341-5206
Practice Address - Fax:847-787-1556
Is Sole Proprietor?:No
Enumeration Date:2009-05-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007535363L00000X
IL209.007535363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209.007535OtherNURSE PRACTITIONER