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General NPI Number Information
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NPI Number | 1538482583
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Entity Type | Organization
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Legal Business Name | JEFF WEISHAAR, PSY.D., P.C.
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Dates
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Enumeration Date | 03/04/2010
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1491 S BELL SCHOOL RD STE 3
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City | ROCKFORD
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State | IL
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Zip | 61108-1407
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Country | US
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Telephone | 866-874-5381
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Fax | 815-261-5963
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Provider Business Mailing Address
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Address Line | W379S9674 COUNTY RD S
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City | EAGLE
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State | WI
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Zip | 53119-1501
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Country | US
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Telephone | 866-874-5381
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFF R. WEISHAAR
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Credential | PSYD
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Telephone | 715-864-9326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071007616
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License Number State | IL
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