Provider Demographics
| NPI: | 1841971058 |
|---|---|
| Name: | PHYSICIAN PARTNERS IN COMPREHENSIVE WEIGHT MANAGEMENT PLLC |
| Entity type: | Organization |
| Organization Name: | PHYSICIAN PARTNERS IN COMPREHENSIVE WEIGHT MANAGEMENT PLLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | MD |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | KARIS |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | TEKWANI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 630-349-5599 |
| Mailing Address - Street 1: | 2501 CHATHAM RD STE 4281 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SPRINGFIELD |
| Mailing Address - State: | IL |
| Mailing Address - Zip Code: | 62704-4188 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 630-349-5599 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 16W300 83RD ST |
| Practice Address - Street 2: | |
| Practice Address - City: | BURR RIDGE |
| Practice Address - State: | IL |
| Practice Address - Zip Code: | 60527-5892 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 630-349-5599 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-07-31 |
| Last Update Date: | 2023-12-02 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2083B0002X | Allopathic & Osteopathic Physicians | Preventive Medicine | Obesity Medicine | Group - Single Specialty |