Provider Demographics
NPI:1265219349
Name:WEIL MIDWEST PODIATRY SERVICES, PLLC
Entity type:Organization
Organization Name:WEIL MIDWEST PODIATRY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:LOWELL
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEIL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-390-7666
Mailing Address - Street 1:1660 FEEHANVILLE DR STE 450
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6023
Mailing Address - Country:US
Mailing Address - Phone:847-390-7666
Mailing Address - Fax:847-390-9345
Practice Address - Street 1:610 S MAPLE AVE STE 2550
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-2807
Practice Address - Country:US
Practice Address - Phone:847-390-7666
Practice Address - Fax:847-390-9345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty