Provider Demographics
NPI:1598881849
Name:WEISS, CHARLES ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ARTHUR
Last Name:WEISS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 S BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-1309
Mailing Address - Country:US
Mailing Address - Phone:630-372-7372
Mailing Address - Fax:630-372-7372
Practice Address - Street 1:523 S BARTLETT RD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-1309
Practice Address - Country:US
Practice Address - Phone:630-372-7372
Practice Address - Fax:630-372-7372
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21621762OtherBLUE CROSS BLUE SHIELD
IL347080Medicare ID - Type Unspecified