Provider Demographics
NPI:1710384573
Name:WEEMS, SOONITI J (DN)
Entity Type:Individual
Prefix:DR
First Name:SOONITI
Middle Name:J
Last Name:WEEMS
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8149 S BLACKSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-4616
Mailing Address - Country:US
Mailing Address - Phone:773-978-6145
Mailing Address - Fax:
Practice Address - Street 1:8149 S BLACKSTONE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-4616
Practice Address - Country:US
Practice Address - Phone:773-978-6145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0265361041C0700X
IL181.000396111NN1001X, 111NR0400X, 172P00000X
IL227.014666225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist