Individual
NICOLE M WYSOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
355 E ERIE ST, CHICAGO, IL 60611-3167
(312) 238-1000
Mailing address
355 E ERIE ST, CHICAGO, IL 60611-3167
(312) 238-1000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036-115589
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036115589
—
IL
Enumeration date
05/09/2007
Last updated
06/24/2022
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