Individual
DR. TAMARA B WYSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 SKOKIE BLVD, SUITE 150, NORTHBROOK, IL 60062-4012
(847) 497-2020
(847) 497-2002
Mailing address
900 SKOKIE BLVD, SUITE 150, NORTHBROOK, IL 60062-4012
(847) 497-2020
(847) 497-2002
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036-092731
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1600854
BCBS OF IL GROUP #
IL
Enumeration date
07/30/2006
Last updated
01/04/2013
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