Organization
HEALTHWISE MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE MYRLANDE KERNIZAN M.D. (OWNER)
(773) 978-5291
Entity
Organization
Contact information
Practice address
8349 S BALTIMORE AVE, CHICAGO, IL 60617-2110
(773) 978-5291
Mailing address
8349 S BALTIMORE AVE, CHICAGO, IL 60617-2110
(773) 978-5291
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036.099858
IL
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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