Provider Demographics
NPI:1467430991
Name:WEIL, FREDERICK MARTIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:MARTIN
Last Name:WEIL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 N RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-7911
Mailing Address - Country:US
Mailing Address - Phone:847-394-2872
Mailing Address - Fax:
Practice Address - Street 1:1585 N BARRINGTON ROAD
Practice Address - Street 2:SUITE 503
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169
Practice Address - Country:US
Practice Address - Phone:847-310-8100
Practice Address - Fax:847-310-8156
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016002559213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016002559Medicaid
IL567220Medicare ID - Type Unspecified
IL016002559Medicaid