Provider Demographics
NPI:1649415001
Name:WEILAND, HEIDI G (CNP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:G
Last Name:WEILAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 E PHILLIP RD
Mailing Address - Street 2:SUITE 1103
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1700
Mailing Address - Country:US
Mailing Address - Phone:847-968-2800
Mailing Address - Fax:847-968-2801
Practice Address - Street 1:6 E PHILLIP RD
Practice Address - Street 2:SUITE 1103
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1700
Practice Address - Country:US
Practice Address - Phone:847-968-2800
Practice Address - Fax:847-968-2801
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily