Individual provider Active NPI

Dara M Weil, PSY.D.

  • Clinical Psychologist
  • Evanston, IL
National Provider Identifier
1740298090
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
600 Davis St
Suite 3E
Evanston, IL 60201-4488
Phone
(312) 458-9258
Fax
(847) 328-4838
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X IL Primary

Addresses

Primary practice location

600 Davis St
Suite 3E
Evanston, IL 60201-4488

Mailing address

1757 N Paulina St
Unit F
Chicago, IL 60622-1157
Phone (773) 384-5310

Other identifiers 1

IdentifierTypeStateIssuer
01634495OtherILBCBS OF IL

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

LicenseStateTypeSpecialty
071-006508ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740298090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 N PAULINA ST",
            "address_2": "UNIT F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221157",
            "telephone_number": "773-384-5310",
            "fax_number": "847-328-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DAVIS ST",
            "address_2": "SUITE 3E",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014488",
            "telephone_number": "312-458-9258",
            "fax_number": "847-328-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIL",
        "first_name": "DARA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "01634495",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.