Lori J Weiss, MD | |
6840 Windsor Ave, Berwyn, IL 60402-3441 | |
(708) 484-0042 | |
(708) 749-5489 |
Full Name | Lori J Weiss |
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Gender | Female |
Speciality | Pediatrics - Adolescent Medicine |
Location | 6840 Windsor Ave, Berwyn, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053314484 | NPI | - | NPPES |
036074273 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080A0000X | Pediatrics - Adolescent Medicine | 036074273 (Illinois) | Primary |
Entity Name | Primary Care Associates Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588731764 PECOS PAC ID: 7416917059 Enrollment ID: O20041018000605 |
Mailing Address | Practice Location Address |
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Lori J Weiss, MD 6840 Windsor Ave, Berwyn, IL 60402-3441 Ph: (708) 484-0042 | Lori J Weiss, MD 6840 Windsor Ave, Berwyn, IL 60402-3441 Ph: (708) 484-0042 |
Dr. Pablo E Chagoya, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 6545 Cermak Rd, Berwyn, IL 60402 Phone: 708-788-0077 | |
Reema Mohammed, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3340 Oak Park Ave Ste 201, Berwyn, IL 60402 Phone: 708-795-5502 | |
Joaquin Lopez, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6238 Cermak Rd, Berwyn, IL 60402 Phone: 708-795-5020 Fax: 708-795-5023 | |
Damayanti S Hathiwala, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3340 Oak Park Ave, Suite 201, Berwyn, IL 60402 Phone: 708-795-5502 Fax: 708-795-5516 | |
Dr. Janardhan Mydam, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-2226 | |
Dr. Joseph Torre, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-2226 |