Wise, Stephen R

Wise, Stephen R is an individual health care provider with primary practice located at 1501 S California Ave , Chicago IL 60608-1732. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Wise, Stephen R can be contacted via phone (773) 257-6710.

Contact Information

Primary practice address
1501 S California Ave Chicago IL 60608-1732
Phone: (773) 257-6710
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036-079109 Illinois

Profile Details

NPI number 1659373371
LBN Legal business name Wise, Stephen R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Dec 6th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659373371 NPPES
Illinois MEDICAID 036-079109-3

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