Lori J Weiss, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

036074273 Issued in IL

Practice address

6840 Windsor Ave
Berwyn, IL 60402-3441

Phone

(708) 484-0042

Fax

(708) 749-5489

NPI assigned

May 31, 2005

Last updated

Feb 14, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primary Care Associates LTD

  • Family Medicine Physician
  • Berwyn, IL
  • NPI 1588731764
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1053314484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 WINDSOR AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023441",
            "telephone_number": "708-484-0042",
            "fax_number": "708-749-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 WINDSOR AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023441",
            "telephone_number": "708-484-0042",
            "fax_number": "708-749-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "LORI",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "036074273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036074273",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• We All Care Home Care Agency
• Kimberly Ann Weber, CRNA
• Sarah Wehrli
• Mary E Weierman, MHP
• Rebecca J Weightman, DMD, MS
• Genet Hagos Weldemichael
• Wellness Path Counseling Services LLC
• Feng Wen, PA-C
• Samantha Marie Wenner
• Larissa Wereszczak

• Pediatric Adolescent Medicine Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Pediatric Adolescent Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.