Provider Demographics
NPI:1679537823
Name:WEINGARTEN, CHARLES Z (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:Z
Last Name:WEINGARTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3633 W LAKE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-5805
Mailing Address - Country:US
Mailing Address - Phone:847-729-9122
Mailing Address - Fax:847-729-9134
Practice Address - Street 1:3633 W LAKE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-5805
Practice Address - Country:US
Practice Address - Phone:847-729-9122
Practice Address - Fax:847-729-9134
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL36039376207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01615422OtherBLUE CROSS BLUE SHIELD
110015344OtherRAILROAD MEDICARE
C38260Medicare UPIN
604520Medicare ID - Type Unspecified