Individual
DR. JOSEPH P. WYSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4905 OLD ORCHARD CTR, LOWER LEVEL, SKOKIE, IL 60077-1425
(847) 679-6707
(847) 679-6721
Mailing address
4905 OLD ORCHARD CTR, LOWER LEVEL, SKOKIE, IL 60077-1425
(847) 679-6707
(847) 679-6721
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036085283
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1605363
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/14/2006
Last updated
05/20/2008
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