Individual
DR. MARC L WIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27W170 SAINT CHARLES RD, CAROL STREAM, IL 60188-1935
(630) 562-9100
(630) 562-9172
Mailing address
27W170 SAINT CHARLES RD, CAROL STREAM, IL 60188-1935
(630) 562-9100
(630) 562-9172
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036076864
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002220114
BCBS NUMBER
IL
05
—
056076864
—
IL
Enumeration date
06/14/2006
Last updated
02/19/2020
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