Healthcare Provider Details

I. General information

NPI: 1770620304
Provider Name (Legal Business Name): FREDERICK M. WEIL, DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 BARRINGTON RD SUITE 503
HOFFMAN ESTATES IL
60194-1090
US

IV. Provider business mailing address

1585 N BARRINGTON RD SUITE 503
HOFFMAN ESTATES IL
60169-5020
US

V. Phone/Fax

Practice location:
  • Phone: 847-310-8100
  • Fax: 847-310-8156
Mailing address:
  • Phone: 847-310-8100
  • Fax: 847-310-8156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016002559
License Number StateIL

VIII. Authorized Official

Name: DR. FREDERICK M WEIL
Title or Position: OWNER
Credential: DPM
Phone: 847-310-8100