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Deactivated NPI 1184646465 Deactivated / Inactive NPI Male Practitioner

Dr. Douglas Weidman , DDS

Dentist - General Practice • Skokie, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Douglas Weidman has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 24, 2006
NPI Deactivation Date May 11, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Douglas Weidman, DDS was a registered Dentist - General Practice practicing in Skokie, IL. Throughout an active medical career spanning 14 years, Dr. Weidman provided care at the practice location at 64 OLD ORCHARD CENTER until profile deactivation on 2020-05-11.

Practice Location & Contact Primary Location

Practice Address

64 Old Orchard Center
Suite 611

Skokie, IL 600771421

Telephone 8476760484

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Skokie, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.0 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
72 Specialists

Practicing in Skokie, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 1915600

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Claudia Rose

Social Worker - Clinical

NPI 1124274725
Dr. Joyce Kocher , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1194994657

Doctor of Medicine (M.D.)

Lesley Placeway , PA-C

Physician Assistant - Surgical

NPI 1437289329

Physician Assistant (Certified)

Dr. Terry Annex , DDS

Dentist - Periodontics

NPI 1568478360

Doctor of Dental Surgery

Dr. Stacey Sacksner , DDS

Dentist - General Practice

NPI 1609932243

Doctor of Dental Surgery

Naomi Bayer , LCSW

Social Worker - Clinical

NPI 1841371358

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 11, 2020

Record deactivated on May 11, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 64 OLD ORCHARD CENTER, SUITE 611, SKOKIE, IL 600771421 (Tel: 8476760484)

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Updated Business Mailing Address July 08, 2007

Registered at 64 OLD ORCHARD CENTER, SUITE 611, SKOKIE, IL 600771421 (Tel: 8476760484)

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Provider Name / Credentials Updated July 08, 2007

Recorded as DOUGLAS WEIDMAN, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #1915600 in IL)

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Initial NPI Registration & Enumeration July 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1184646465
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 24, 2006
Last Update: July 08, 2007
Deactivation Date: May 11, 2020

Mailing Address

64 Old Orchard Center, Suite 611

Skokie, IL 600771421

Phone: 8476760484

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.