Gary Wiesman MD. LTD

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

036042623 Issued in IL

Legal business name

GARY WIESMAN MD. LTD

Practice address

712 N Dearborn St
Chicago, IL 60654-3846

Phone

(312) 796-5550

Fax

(312) 981-1292

NPI assigned

Oct 28, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gary G Wiesman, MDNPI 1821191404

Title

President

Phone

(312) 796-5550

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary G Wiesman, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Chicago, IL
  • NPI 1821191404
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1215180757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543846",
            "telephone_number": "312-796-5550",
            "fax_number": "312-981-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543846",
            "telephone_number": "312-796-5550",
            "fax_number": "312-981-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY WIESMAN MD. LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A",
        "authorized_official_last_name": "WIESMAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-796-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IL",
            "license": "036042623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary L. Williams DPM PC
• Gary L. Williams DPM PC
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• Gary R. Olson DDS, PC
• Gary V Rubin MD
• Rafael Garza Castillon Jr., M.D.
• Regina Garza Elizondo
• Lorena Garza Garcia, MD
• Garza Therapeutic Play Inc
• Elsa Marina Garza-Shalaveyus, LCPC

• Otolaryngology/Facial Plastic Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.