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General NPI Number Information
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NPI Number | 1225847064
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Entity Type | Individual
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Provider Name | SEAN MICHAEL WEESE FNP
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Gender | Male
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 1325 REMINGTON RD STE X
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City | SCHAUMBURG
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State | IL
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Zip | 60173-4815
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Country | US
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Telephone | 630-237-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 1652 HEIDORN AVE
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City | WESTCHESTER
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State | IL
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Zip | 60154-4116
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Country | US
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Telephone | 224-622-6303
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209031109
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License Number State | IL
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