Provider Demographics
NPI:1295539575
Name:WEESE, LOREN (APRN)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:
Last Name:WEESE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 BURR RIDGE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-0833
Mailing Address - Country:US
Mailing Address - Phone:630-832-1775
Mailing Address - Fax:630-832-3078
Practice Address - Street 1:545 BELMONT LN
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2467
Practice Address - Country:US
Practice Address - Phone:630-523-8972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209031987363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health