Individual
DR. MARY R. WYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
225 E CHICAGO AVE # 9, CHICAGO, IL 60611-2991
(312) 227-4500
(312) 227-9785
Mailing address
225 E CHICAGO AVE # 9, CHICAGO, IL 60611-2991
(312) 227-4500
(312) 227-9785
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
036-105455
IL
2085R0202X
Diagnostic Radiology Physician
036-105455
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105455
—
IL
Enumeration date
09/06/2005
Last updated
09/21/2023
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