Individual
DR. MICHAEL WIISANEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9169
Mailing address
870 N ORLEANS ST, APT 3, CHICAGO, IL 60610-3029
(701) 610-1999
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036122167
IL
207L00000X
Anesthesiology Physician
Primary
125053372
IL
Other
Enumeration date
07/07/2008
Last updated
10/31/2024
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