Individual
DOUGLAS WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7447 W TALCOTT AVE STE 427, CHICAGO, IL 60631-3715
(773) 990-4024
Mailing address
7447 W TALCOTT AVE STE 427, CHICAGO, IL 60631-3715
(773) 990-4024
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036150881
IL
Other
Enumeration date
06/15/2010
Last updated
10/28/2019
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