Provider Demographics
NPI:1568089381
Name:WEISS, CHERYL PALER (LCPC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:PALER
Last Name:WEISS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:PAZ
Other - Last Name:PALER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2453 W WARNER AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-2868
Mailing Address - Country:US
Mailing Address - Phone:630-362-1629
Mailing Address - Fax:
Practice Address - Street 1:4101 N RAVENSWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2193
Practice Address - Country:US
Practice Address - Phone:773-432-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180012638101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health