Individual
DR. MARK K ISONIEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 E WILLOW AVE, WHEATON, IL 60187-5476
(630) 510-6900
(630) 871-6706
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036101563
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101563
—
IL
01
—
P00612657
RR MEDICARE
IL
Enumeration date
06/16/2006
Last updated
08/08/2023
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