Active NPI
Donna Weisensel, DACM, LAC, LMT
- Acupuncturist
- Island Lake, IL
National Provider Identifier
1164033361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 198.001476
- Practice address
- 4708 Southhampton Dr
Island Lake, IL 60042-8470 - Phone
- (847) 769-1575
- NPI assigned
- Aug 11, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 994-55 | WI | |
| Massage Therapist | 225700000X | 227.016803 | IL | |
| Acupuncturist | 171100000X | 198.001476 | IL | Primary |
Addresses
Primary practice location
4708 Southhampton Dr
Island Lake, IL 60042-8470
Mailing address
4708 Southhampton Dr
Island Lake, IL 60042-8470
Phone (847) 769-1575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 198.001476 | IL | MD | Acupuncturist |
| 994-55 | WI | MD | Acupuncturist |
| 227.016803 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597104000000",
"number": "1164033361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4708 SOUTHHAMPTON DR",
"city": "ISLAND LAKE",
"state": "IL",
"postal_code": "600428470",
"telephone_number": "847-769-1575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4708 SOUTHHAMPTON DR",
"city": "ISLAND LAKE",
"state": "IL",
"postal_code": "600428470",
"telephone_number": "847-769-1575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISENSEL",
"first_name": "DONNA",
"credential": "DACM, LAC, LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-11",
"last_updated": "2020-08-11",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WI",
"license": "994-55",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.016803",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "IL",
"license": "198.001476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Island Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.