Individual provider Active NPI

Dana Weber, PH.D.

  • Psychologist
  • Hines, IL
National Provider Identifier
1174943625
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.008815 Issued in IL
Practice address
5000 S 5TH Ave
Trauma Services Program, BLDG 228, 4-South
Hines, IL 60141-3030
Phone
(708) 202-4761
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.008815 IL Primary

Addresses

Primary practice location

5000 S 5TH Ave
Trauma Services Program, BLDG 228, 4-South
Hines, IL 60141-3030

Mailing address

5000 S 5TH Ave
Trauma Services Program, BLDG 228, 4-South
Hines, IL 60141-3030
Phone (708) 202-4761

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.008815ILMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1174943625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "address_2": "TRAUMA SERVICES PROGRAM, BLDG 228, 4-SOUTH",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-202-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "address_2": "TRAUMA SERVICES PROGRAM, BLDG 228, 4-SOUTH",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-202-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.008815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.