Organization
IRVIN WIESMAN, MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRVIN M WIESMAN MD (PRESIDENT)
(773) 275-5550
Entity
Organization
Contact information
Practice address
712 N DEARBORN ST, CHICAGO, IL 60654-3818
(773) 275-5550
(312) 981-1292
Mailing address
712 N DEARBORN ST, CHICAGO, IL 60654-3818
(773) 275-5550
(312) 981-1292
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036095961
IL
Other
Enumeration date
05/14/2009
Last updated
11/06/2015
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