Individual
WAYNE H WIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9600 GROSS POINT RD, SKOKIE, IL 60076-1214
(847) 933-6721
Mailing address
PO BOX 88641, CHICAGO, IL 60680-1641
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360530512
—
IL
Enumeration date
05/23/2006
Last updated
07/12/2007
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