Individual
MICHAEL WIERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
545 NEWPORT CT, ISLAND LAKE, IL 60042-9137
(847) 526-4700
Mailing address
358 COLLEGE ST APT E, CRYSTAL LAKE, IL 60014-6000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2419059
IL
Other
Enumeration date
08/27/2020
Last updated
08/27/2020
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