Healthcare Provider Details

I. General information

NPI: 1033250022
Provider Name (Legal Business Name): DAVID ENGLAND WEAVER III LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N YORK RD SUITE 107
HINSDALE IL
60521-2950
US

IV. Provider business mailing address

950 N YORK RD SUITE 107
HINSDALE IL
60521-2950
US

V. Phone/Fax

Practice location:
  • Phone: 630-986-5403
  • Fax: 630-986-0815
Mailing address:
  • Phone: 630-986-5403
  • Fax: 630-986-0815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: