Provider Demographics
NPI:1467772376
Name:WEBER, NICHOLAS HJORT (DO)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:HJORT
Last Name:WEBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2845 N SHERIDAN RD FL 6
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-7227
Mailing Address - Country:US
Mailing Address - Phone:773-665-8400
Mailing Address - Fax:773-665-5182
Practice Address - Street 1:2845 N SHERIDAN RD FL 6
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-7227
Practice Address - Country:US
Practice Address - Phone:773-665-8400
Practice Address - Fax:773-665-5182
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.138147208100000X, 2081S0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine