Provider Demographics
NPI:1134415573
Name:WEISS, SAMANTHA BRITT (DC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:BRITT
Last Name:WEISS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E WOODFIELD RD
Mailing Address - Street 2:STE 116
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4717
Mailing Address - Country:US
Mailing Address - Phone:847-330-8200
Mailing Address - Fax:847-330-8205
Practice Address - Street 1:800 E WOODFIELD RD
Practice Address - Street 2:STE 116
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4717
Practice Address - Country:US
Practice Address - Phone:847-330-8200
Practice Address - Fax:847-330-8205
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor