MEDICARE: MS. BETSY ANN WEISS R.N.,M.S.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	209.002275	IL

General Provider Information

NPI Number	:	1568727063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BETSY ANN WEISS R.N.,M.S.N.

Provider Business Mailing Address
First Line	:	310 OLD POST RD
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-1527
Country	:	US
Telephone Number	:	847-564-0476
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 OLD POST RD
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-1527
Country	:	US
Telephone Number	:	847-564-0476
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2012
Last Update Date	:	07/10/2012

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