Provider Demographics
NPI:1669063806
Name:WEISNER, BRIANA CHRISTINE (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRIANA
Middle Name:CHRISTINE
Last Name:WEISNER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7270 N ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-2414
Mailing Address - Country:US
Mailing Address - Phone:419-799-1260
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 1530
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4000
Practice Address - Country:US
Practice Address - Phone:419-799-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-31
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.010465103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical