Provider Demographics
NPI:1366840712
Name:ZHENG, WEICHAO
Entity Type:Individual
Prefix:
First Name:WEICHAO
Middle Name:
Last Name:ZHENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 W EADS ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-1597
Mailing Address - Country:US
Mailing Address - Phone:217-417-6867
Mailing Address - Fax:
Practice Address - Street 1:912 W EADS ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-1597
Practice Address - Country:US
Practice Address - Phone:217-417-6867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program