Individual
DR. RICHARD J WIET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 SALT CREEK LN, SUITE 101, HINSDALE, IL 60521-2990
(630) 789-3110
(630) 789-3137
Mailing address
11 SALT CREEK LN, SUITE 101, HINSDALE, IL 60521-2990
(630) 789-3110
(630) 789-3137
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
036-047459
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36047459
—
IL
01
—
400280
GROUP MEDICARE PTAN
IL
01
—
403270
MEDICARE GROUP PTAN
IL
Enumeration date
11/15/2005
Last updated
03/18/2015
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