Organization
WILLIAM J WISE MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY B WISE MD (CO OWNER OF CORPORATION)
(708) 352-3849
Entity
Organization
Contact information
Practice address
7729 OGDEN AVE, LYONS, IL 60534
(708) 447-2238
(708) 447-2264
Mailing address
320 SUNSET AVE, LA GRANGE, IL 60525-2179
(708) 447-2238
(708) 447-2264
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
IL
207RN0300X
Nephrology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/21/2006
Last updated
09/11/2025
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