Basic Information
| Provider Information | |||||||||
| NPI: | 1386638997 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEAVER | ||||||||
| FirstName: | CURTIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 241 W 17TH ST | ||||||||
| Address2: | |||||||||
| City: | LOMBARD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601486138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309167992 | ||||||||
| FaxNumber: | 6307520145 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 DANADA SQ W | ||||||||
| Address2: | |||||||||
| City: | WHEATON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601892041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307520595 | ||||||||
| FaxNumber: | 6307520145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2005 | ||||||||
| LastUpdateDate: | 02/26/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 046-007064 | IL | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.