Provider Demographics
NPI:1013259779
Name:WEINSTEIN, ALLAN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:JOSEPH
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 E GOETHE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2628
Mailing Address - Country:US
Mailing Address - Phone:312-944-8478
Mailing Address - Fax:312-944-8483
Practice Address - Street 1:65 E GOETHE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-2628
Practice Address - Country:US
Practice Address - Phone:312-944-8478
Practice Address - Fax:312-944-8483
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.113264207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease