Provider Demographics
NPI:1689820524
Name:WEINBERG, MICHAEL G (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:G
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:1475 N DILLEYS RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-1708
Mailing Address - Country:US
Mailing Address - Phone:847-249-8800
Mailing Address - Fax:847-249-8869
Practice Address - Street 1:1475 N DILLEYS ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5305
Practice Address - Country:US
Practice Address - Phone:847-249-8800
Practice Address - Fax:847-249-8869
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0190230091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics