Organization
GARY WIESMAN MD. LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY G WIESMAN MD (PRESIDENT)
(312) 796-5550
Entity
Organization
Contact information
Practice address
712 N DEARBORN ST, CHICAGO, IL 60654-3846
(312) 796-5550
(312) 981-1292
Mailing address
712 N DEARBORN ST, CHICAGO, IL 60654-3846
(312) 796-5550
(312) 981-1292
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
036042623
IL
Other
Enumeration date
10/28/2008
Last updated
04/10/2020
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