Individual
JILL WIRTH-RISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
205 N CUMMINGS LN, WASHINGTON, IL 61571-2181
(309) 643-6210
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0001
(309) 672-4809
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036119699
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036119699
LICENSE
IL
Enumeration date
05/03/2007
Last updated
01/24/2020
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