Irvin Michael Wiesman MD

NPI 1194897587 - Plastic Surgery - 208200000X

NPI Details
NPI 1194897587
Gender Male
Enumeration Date 11/14/2006
Last Updated 06/11/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
712 N DEARBORN ST
CHICAGO IL, 60654-3818, US
Phone (312) 981-1290
Fax (312) 981-1292
Business Location
712 N DEARBORN ST
CHICAGO IL, 60654-3818, US
Phone (312) 981-1290
Fax (312) 981-1292
Toxanomy
Taxonomy Code 208200000X
License State Illinois
License Number 036095961
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According to our database, Dr. Irvin Michael Wiesman MD NPI is 1194897587, taxonomy code is 208200000X and license number is 036095961, license state is located at Illinois. Irvin Michael Wiesman MD physically located at 712 N Dearborn St, Chicago IL, 60654-3818. NPI Number Irvin Michael Wiesman MD has the Individual type.

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1194897587 NPI number is provided on an as is basis without warranty of any kind. 1194897587 is maintained by the National Plan & Provider Enumeration System. The contents of Irvin Michael Wiesman MD are for informational purposes only.