Individual provider Active NPI

Mark D Weigel, DDS

  • General Practice Dentistry
  • Schaumburg, IL
National Provider Identifier
1780804666
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19-018103 Issued in IL
Practice address
1066 S Roselle Rd
Schaumburg, IL 60193-3961
Phone
(847) 985-6660
Fax
(847) 985-1774
NPI assigned
Apr 26, 2007
Sex
Male
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
General Practice Dentistry 1223G0001X 19-018103 IL Primary

Addresses

Primary practice location

1066 S Roselle Rd
Schaumburg, IL 60193-3961

Mailing address

936 S Hillcrest Ave
Elmhurst, IL 60126-5311
Phone (630) 941-3473

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
19-018103ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780804666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 S HILLCREST AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265311",
            "telephone_number": "630-941-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 S ROSELLE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933961",
            "telephone_number": "847-985-6660",
            "fax_number": "847-985-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIGEL",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19-018103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, 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.