MEDICARE: DR. LOWELL SCOTT WEIL JR. DPM

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	213E00000X	Podiatrist	016-004770	IL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	016004770	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	517522	OTHER	IL	MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	60000380	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1942208558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOWELL SCOTT WEIL JR. DPM

Provider Business Mailing Address
First Line	:	1660 FEEHANVILLE DR STE 100
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-6019
Country	:	US
Telephone Number	:	847-390-7666
Fax Number	:	847-390-9345

Provider Business Practice Location Address
First Line	:	1660 FEEHANVILLE DR STE 450
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-6023
Country	:	US
Telephone Number	:	847-390-7666
Fax Number	:

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/16/2021

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Directions to “ DR. LOWELL SCOTT WEIL JR. DPM” Practice Location

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