Healthcare Provider Details

I. General information

NPI: 1710965314
Provider Name (Legal Business Name): WEIL FOOT AND ANKLE INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 FEEHANVILLE DR STE 100
MOUNT PROSPECT IL
60056-6019
US

IV. Provider business mailing address

PO BOX 848195
LOS ANGELES CA
90084-8195
US

V. Phone/Fax

Practice location:
  • Phone: 472-509-6298
  • Fax: 224-220-9743
Mailing address:
  • Phone: 847-390-7666
  • Fax: 224-220-9345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LOWELL SCOTT WEIL JR.
Title or Position: EXECUTIVE CHAIRMAN
Credential: DPM
Phone: 847-390-7666