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NPI Code Detail

MEDICARE: REBECCA LEA WEISS-COLEMAN M.D.

MEDICARE: REBECCA LEA WEISS-COLEMAN M.D.
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
1207QA0505XAdult Medicine Physician036108337IL
2207Q00000XFamily Medicine Physician036108337IL

General Provider Information

NPI Number : 1851330476
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA LEA WEISS-COLEMAN M.D.
Provider Business Mailing Address
First Line : 150 E HURON ST STE 1100
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2948
Country : US
Telephone Number : 312-926-3627
Fax Number : 312-926-6285
Provider Business Practice Location Address
First Line : 6810 N MCCORMICK BLVD
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-2709
Country : US
Telephone Number : 847-674-6900
Fax Number : 847-329-4728
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 04/07/2021

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