Provider Demographics
NPI:1699181826
Name:WEILAND, DAISY MENDEZ (OD)
Entity Type:Individual
Prefix:DR
First Name:DAISY
Middle Name:MENDEZ
Last Name:WEILAND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2202
Mailing Address - Country:US
Mailing Address - Phone:224-255-6450
Mailing Address - Fax:224-255-6271
Practice Address - Street 1:548 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2202
Practice Address - Country:US
Practice Address - Phone:224-255-6450
Practice Address - Fax:224-255-6271
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010810152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist