Provider Demographics
NPI:1962707117
Name:WEISS, DEBBIE LEESA (MD)
Entity type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:LEESA
Last Name:WEISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:847-390-4757
Practice Address - Street 1:912 NORTHWEST HWY
Practice Address - Street 2:SUITE 107
Practice Address - City:FOX RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60021-1925
Practice Address - Country:US
Practice Address - Phone:847-462-5100
Practice Address - Fax:847-462-5101
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.070974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine