Provider Demographics
NPI:1124180781
Name:WEISZ, CAREN LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:CAREN
Middle Name:LYNN
Last Name:WEISZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CAREN
Other - Middle Name:LYNN
Other - Last Name:WEISZ-GREENSPAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, OD
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:3064 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-1130
Practice Address - Country:US
Practice Address - Phone:815-744-6735
Practice Address - Fax:815-744-6703
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007035152WP0200X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046007035Medicaid
IL03574OtherSPECTERA
IL3120OtherDAVIS VISION
IL115683OtherEYEMED
IL3120OtherDAVIS VISION