Individual provider · Type 1 NPI

Logan Hayes Weatherford, NEURPHYSIOLOGIST

Surgical Physician Assistant · Mokena, IL

NPI number 1205548864 Active

Practice location

18761 Chestnut Ct
Mokena, IL 60448-9501

Call (786) 448-9020 Map

Mailing address

7455 W Washington Ave Ste 302
Las Vegas, NV 89128-4340

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X238.010990 (IL)
Surgical Assistant 246ZC0007X238.010990 (IL)
Electroneurodiagnostic Specialist/Technologist 246ZE0600XNone listed

Surgical Physician Assistant: Definition to come...

10 other providers at this address

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About NPI 1205548864

Logan Hayes Weatherford, NEURPHYSIOLOGIST's National Provider Identifier is 1205548864, issued on Dec 14, 2022. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Mokena, IL. The record was last updated on Jun 24, 2026.