Wistenberg, Lexy
Wistenberg, Lexy is an individual health care provider with primary practice located at 6131 Dempster St , Morton Grove IL 60053-2953. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Wistenberg, Lexy can be contacted via phone (847) 967-5010.Contact Information
Primary practice address
6131 Dempster St
Morton Grove IL 60053-2953
Phone: (847) 967-5010
Fax: (847) 967-5147
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036082382 | Illinois |
Profile Details
| NPI number | 1750389201 |
|---|---|
| LBN Legal business name | Wistenberg, Lexy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2005 |
| Last updated | May 12th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750389201 | NPPES |
| Illinois | Other | 01632926 | BLUE CROSS BLUE SHIELD |
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