Provider Demographics
NPI:1336773605
Name:WEIR, KHAREL (CLT, CPM)
Entity Type:Individual
Prefix:MS
First Name:KHAREL
Middle Name:
Last Name:WEIR
Suffix:
Gender:F
Credentials:CLT, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2187
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60303-2187
Mailing Address - Country:US
Mailing Address - Phone:703-951-3147
Mailing Address - Fax:
Practice Address - Street 1:327 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2921
Practice Address - Country:US
Practice Address - Phone:703-951-3147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical