Provider Demographics
NPI:1215944632
Name:WEBER, DAVID JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSEPH
Last Name:WEBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 SINSINAWA AVE
Mailing Address - Street 2:
Mailing Address - City:EAST DUBUQUE
Mailing Address - State:IL
Mailing Address - Zip Code:61025-1220
Mailing Address - Country:US
Mailing Address - Phone:815-747-6548
Mailing Address - Fax:815-747-6549
Practice Address - Street 1:289 SINSINAWA AVE
Practice Address - Street 2:
Practice Address - City:EAST DUBUQUE
Practice Address - State:IL
Practice Address - Zip Code:61025-1220
Practice Address - Country:US
Practice Address - Phone:815-747-6548
Practice Address - Fax:815-747-6549
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-003755111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37447Medicare UPIN
IL646110Medicare ID - Type Unspecified