Provider Demographics
NPI:1366412587
Name:WEBER, ELYSE M (MS)
Entity type:Individual
Prefix:MS
First Name:ELYSE
Middle Name:M
Last Name:WEBER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SPALDING DR STE 111
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6766
Mailing Address - Country:US
Mailing Address - Phone:630-646-6093
Mailing Address - Fax:630-548-6617
Practice Address - Street 1:120 SPALDING DR STE 111
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6766
Practice Address - Country:US
Practice Address - Phone:630-646-6093
Practice Address - Fax:630-548-6617
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS