Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Zachary Jordan Weiss

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1073908901

Zachary Jordan Weiss is a Student in an Organized Health Care Education/Training Program in Maywood, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

2160 S 1st Ave Bldg 105 Ste 1814
Maywood, IL 60153-3328
Phone: (888) 584-7888
Fax: (708) 216-5560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019030549 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1073908901
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 30, 2015
Last updated in NPPESFebruary 22, 2018

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