Dr Stephen R Wise, MD | |
1501 S California Ave, Chicago, IL 60608-1732 | |
(773) 257-6710 | |
Not Available |
Full Name | Dr Stephen R Wise |
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Gender | Male |
Speciality | Surgery |
Location | 1501 S California Ave, Chicago, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659373371 | NPI | - | NPPES |
036-079109-3 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
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208600000X | Surgery | 036-079109 (Illinois) | Primary |
Entity Name | Mount Sinai Community Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376715896 PECOS PAC ID: 5991600405 Enrollment ID: O20040202001032 |
Mailing Address | Practice Location Address |
---|---|
Dr Stephen R Wise, MD 3537 Paysphere Cir, Chicago, IL 60674-0035 Ph: (708) 786-2900 | Dr Stephen R Wise, MD 1501 S California Ave, Chicago, IL 60608-1732 Ph: (773) 257-6710 |
Raelene D Kennedy, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1725 W Harrison St Ste 810, Chicago, IL 60612 Phone: 312-942-5500 | |
Douglas Wiseman, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 7447 W Talcott Ave Ste 427, Chicago, IL 60631 Phone: 773-990-4024 | |
Dr. Bobiejo Ava Ferguson Bryan, MD Surgery Medicare: Medicare Enrolled Practice Location: 5841 S Maryland Ave # Mc6040, Chicago, IL 60637 Phone: 773-702-1000 Fax: 773-702-2140 | |
Adam Lam, MD Surgery Medicare: Medicare Enrolled Practice Location: 5841 S Maryland Ave # Mc6040, Chicago, IL 60637 Phone: 773-702-1000 Fax: 773-702-2140 | |
Kabeer Rajan Masih, MD Surgery Medicare: Medicare Enrolled Practice Location: 1620 W Harrison St, Chicago, IL 60612 Phone: 312-942-5000 | |
Jay Prystowsky, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 680 N Lake Shore Dr, Suite 1000, Chicago, IL 60611 Phone: 312-695-9797 | |
Heron Rodriguez, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 675 N Saint Clair St, Northwestern Memorial Hospialt Galter 19-100, Chicago, IL 60611 Phone: 312-695-2714 |