Individual
EMILY WIEZOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
101 E PLUMMER BLVD, CHATHAM, IL 62629-8047
(217) 483-3487
(217) 483-8150
Mailing address
101 E PLUMMER BLVD, CHATHAM, IL 62629-8047
(217) 483-3487
(217) 483-8150
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209015128
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F1016555
AANP CERTIFICATION
IL
Enumeration date
12/06/2016
Last updated
12/06/2016
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