Provider Demographics
NPI:1922606995
Name:WEIGEL, CASSIA YUECHUN
Entity Type:Individual
Prefix:
First Name:CASSIA
Middle Name:YUECHUN
Last Name:WEIGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N MAIN ST APT 5S
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-1576
Mailing Address - Country:US
Mailing Address - Phone:510-846-1024
Mailing Address - Fax:
Practice Address - Street 1:601 N MAIN ST APT 5S
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-1576
Practice Address - Country:US
Practice Address - Phone:510-846-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty