Healthcare Provider Details

I. General information

NPI: 1326952375
Provider Name (Legal Business Name): LISA WEINGART MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROOSEVELT RD STE E220
GLEN ELLYN IL
60137-5868
US

IV. Provider business mailing address

3001 RIDGELAND AVE
LISLE IL
60532-1674
US

V. Phone/Fax

Practice location:
  • Phone: 630-216-4038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.131689
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: