Provider Demographics
NPI:1225847064
Name:WEESE, SEAN MICHAEL (FNP)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL
Last Name:WEESE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 HEIDORN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-4116
Mailing Address - Country:US
Mailing Address - Phone:224-622-6303
Mailing Address - Fax:
Practice Address - Street 1:1325 REMINGTON RD STE X
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4815
Practice Address - Country:US
Practice Address - Phone:630-237-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209031109363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner