DR. GARY G WIESMAN (NPI# 1821191404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821191404 |
| Entity Type | Individual |
| Full Name | DR. GARY G WIESMAN |
| Credential | MD |
| Practice Address |
712 N Dearborn St Chicago IL 60654-3846 |
| Practice Telephone | 3127965550 |
| Practice Fax Number | 3129811292 |
| Mailing Telephone | 3127965550 |
| Mailing Fax Number | 3129811292 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-04-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
036042623 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036042623 | 05 | |
| IL | BCBS | 01621610 | 01 |
| Street Address |
712 N DEARBORN ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60654-3846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033754320 | Audrey R Snyder | Physician Assistant | 712 N Dearborn St, Chicago, IL 60654-3846 | 2019-11-11 |
| 1134777311 | Iv Solution & Infusion Centers, LLC | Anesthesiology | 712 N Dearborn St, Chicago, IL 60654-3846 | 2019-08-30 |
| 1073080909 | Kierra La Shawn Bruno-rodgers | Orthopaedic Surgery | 712 N Dearborn St, Chicago, IL 60654-3846 | 2018-10-29 |
| 1609375021 | Kelly Diamond | Physician Assistant | 712 N Dearborn St, Chicago, IL 60654-3846 | 2018-02-12 |
| 1578096749 | Midwest Specialty Pharmacy LLC | Pharmacy | 712 N Dearborn St, Ste. 3a, Chicago, IL 60654-3846 | 2017-04-05 |
| 1700246592 | Anesthesia Associates of Chicago Inc | Anesthesiology | 712 N Dearborn St, Chicago, IL 60654-3846 | 2016-03-07 |
| 1891104246 | New Focus Medicine LLC | Clinic/Center | 712 N Dearborn St, Chicago, IL 60654-3846 | 2014-08-11 |
| 1659700151 | Brittany Macleod | Physician Assistant | 712 N Dearborn St, Chicago, IL 60654-3846 | 2013-11-05 |
| 1831527290 | Ora Dental Group, LLC | Dentist | 712 N Dearborn St, 4th Floor, Chicago, IL 60654-3846 | 2013-10-23 |
| 1205192978 | Illinois Orthopedic Network, LLC | Neuromusculoskeletal Medicine, Sports Medicine | 712 N Dearborn St, Chicago, IL 60654-3818 | 2012-04-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912523564 | Male-order Men's Health LLC | Pharmacy | 710 N. Dearborn St., Chicago, IL 60654 | 2020-06-19 |
| 1669014924 | Tanner John Magee | Chiropractor | 415 N. Lasalle St., Suite 605, Chicago, IL 60654 | 2019-10-08 |
| 1144873886 | Fraeda Friedman | Social Worker | 451 N Lasalle Dr, Chicago, IL 60654 | 2019-07-22 |
| 1568024040 | Robin Elizabeth Miller | Dietitian, Registered | 770 North Lasalle Street, Suite 800, Chicago, IL 60654 | 2019-07-03 |
| 1487115804 | Ontario Street Operatory Fac | Clinic/Center | 22 W Ontario Street Operatory, Chicago, IL 60654 | 2019-03-28 |
| 1134697683 | Ghazal Kermani | Dentist | 350 North Clark Street, Suite 600, Chicago, IL 60654 | 2018-11-02 |
| 1225516842 | Tyler Jonathan Hinkel | Radiology | 33 W Ontario St Apt 46f, Chicago, IL 60654 | 2018-08-06 |
| 1710495312 | Mia Zarlengo | Dietitian, Registered | 770 N Lasalle Dr, 800, Chicago, IL 60654 | 2018-01-17 |
| 1568970341 | Kelly Lyons | Acupuncturist | 770 N Lasalle St., Suite 800, Chicago, IL 60654 | 2018-01-16 |
| 1407367568 | Amy Mcnicholas | Counselor | 721 N Lasalle, Chicago, IL 60654 | 2017-10-17 |
| Find all providers in zip 60654 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023214426 | Otolaryngology Associates Sc | Otolaryngology | 233 E Erie St Ste 804, Chicago, IL 60611-2906 | 2007-06-22 |
| 1609805985 | Howard Shane Kotler | Otolaryngology | 2555 S. Martin Luther King Dr., Chicago, IL 60616 | 2006-06-30 |
| 1477184562 | Chicago Nose and Sinus LLC | Otolaryngology | 680 N Lake Shore Dr Ste 1425, Chicago, IL 60611-4451 | 2020-01-28 |
| 1215180757 | Gary Wiesman Md. Ltd | Otolaryngology | 712 N Dearborn St, Chicago, IL 60654-3846 | 2008-10-28 |
| 1801857545 | James B Lucas II | Otolaryngology | 1855 W Taylor St, Mc 648 Room 2.42, Chicago, IL 60612-7242 | 2006-03-31 |
| 1831184001 | Stephen Philip Becker | Otolaryngology | 233 E Erie St, 804, Chicago, IL 60611-2926 | 2005-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326338526 | Sudeep Roy | Otolaryngology | 1640 N Arlington Heights Rd Ste 210, Arlington Heights, IL 60004-3985 | 2011-04-10 |
| 1487834958 | Ryan C Vaughn | Otolaryngology | 814 E Woodfield Rd, Schaumburg, IL 60173-4714 | 2007-11-13 |
| 1982769717 | Anthony James Geroulis | Otolaryngology | 330 West Frontage Rd., Northfield, IL 60093 | 2006-12-22 |
| 1912926205 | Bryan W Rubach | Otolaryngology | 2040 Ogden Ave Ste 301, Aurora, IL 60504-7205 | 2006-07-18 |
| 1447288303 | Thomas E. Turcotte Jr. | Otolaryngology | 215 E. 1st St., Suite #315, Ksb Medical Group, Dixon, IL 61021 | 2006-06-29 |
| 1780935197 | Jeffrey Ryan Sparks | Otolaryngology | 515 E Grant St, Suite 113, Macomb, IL 61455-3368 | 2012-09-25 |
| 1326321431 | Bernard Carl Pecaro | Otolaryngology | 383 S Schmale Rd, Carol Stream, IL 60188-2756 | 2011-09-25 |
| 1043507908 | Kartike Gulati | Otolaryngology | 3700 W 203rd St, Olympia Fields, IL 60461 | 2011-06-29 |
| 1407098544 | William Panje Md Sc | Otolaryngology | 6703 159th St, Tinley Park, IL 60477-1781 | 2009-04-06 |
| 1720273378 | Sanjay Pradeep Keni | Otolaryngology | 6420 W 127th St, Palos Heights, IL 60463-2269 | 2007-09-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.