Individual
KRISTIN MARIE WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 SPALDING DR STE 102, NAPERVILLE, IL 60540-6551
(630) 871-6699
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125:056429
IL
207RP1001X
Pulmonary Disease Physician
Primary
036.130309
IL
Other
Enumeration date
06/09/2009
Last updated
06/15/2023
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