Individual
DR. ADAM WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(740) 438-8789
Mailing address
322 WASHINGTON BLVD APT 1I, OAK PARK, IL 60302-4165
(740) 438-8789
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125080835
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
03/23/2022
Last updated
06/14/2022
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