Provider Demographics
NPI:1740298090
Name:WEIL, DARA M (PSYD)
Entity type:Individual
Prefix:DR
First Name:DARA
Middle Name:M
Last Name:WEIL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
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Mailing Address - Street 1:1757 N PAULINA ST
Mailing Address - Street 2:UNIT F
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-1157
Mailing Address - Country:US
Mailing Address - Phone:773-384-5310
Mailing Address - Fax:847-328-4838
Practice Address - Street 1:600 DAVIS ST
Practice Address - Street 2:SUITE 3E
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4488
Practice Address - Country:US
Practice Address - Phone:312-458-9258
Practice Address - Fax:847-328-4838
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01634495OtherBCBS OF IL