Individual
MS. LISA WIELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1441 BRANDING AVE STE 310, DOWNERS GROVE, IL 60515-5624
(630) 829-1038
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-009648
IL
363LA2200X
Adult Health Nurse Practitioner
209.009648
IL
Other
Enumeration date
10/12/2012
Last updated
07/15/2022
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