| NPI | 1215180757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY G WIESMAN President 312-796-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IL 036042623) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2020-04-10 |