Provider Demographics
NPI:1538128517
Name:WEINBERG, CAROL R (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:R
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 BROM CT STE 101
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6533
Mailing Address - Country:US
Mailing Address - Phone:630-717-1771
Mailing Address - Fax:630-717-0091
Practice Address - Street 1:720 BROM CT STE 101
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6533
Practice Address - Country:US
Practice Address - Phone:630-717-1771
Practice Address - Fax:630-717-0091
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036072940207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36072940Medicaid
E24614Medicare UPIN
IL552410Medicare PIN