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Contact Information

BLAKE A WEIS, MD
611 W PARK ST
URBANA, IL61801
 Phone: 217-383-3311
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for BLAKE A WEIS · (Male)

NPI # 1801236617
Status Active
Credentials MD
Entity Individual
Enumeration date 06/26/2013
Last updated 12/04/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 61241
  • IL License # 036150541
  • MO License # 2013018930
  • MO License # 2014034042
Hospital affiliation(s)
  • CARLE FOUNDATION HOSPITAL - (Acute Care)
    611 WEST PARK STREET
    URBANA, IL 61801
  • GIBSON COMMUNITY HOSPITAL - (Critical Access)
    1120 N MELVIN STREET
    GIBSON CITY, IL 60936
  • HOOPESTON COMMUNITY MEMORIAL HOSPITAL - (Critical Access)
    701 EAST ORANGE STREET
    HOOPESTON, IL 60942
  • RICHLAND MEMORIAL HOSPITAL - (Acute Care)
    800 EAST LOCUST
    OLNEY, IL 62450
  • RIVERSIDE MEDICAL CENTER - (Acute Care)
    350 N WALL ST
    KANKAKEE, IL 60901
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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