Provider Demographics
NPI:1396804175
Name:WISNIEWSKI, KARY K (MD)
Entity type:Individual
Prefix:DR
First Name:KARY
Middle Name:K
Last Name:WISNIEWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KARY
Other - Middle Name:KALTENBRONN
Other - Last Name:WISNIEWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:801 S. WASHINGTON ST.
Mailing Address - Street 2:EDWARD HOSPITAL
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540
Mailing Address - Country:US
Mailing Address - Phone:630-527-5144
Mailing Address - Fax:
Practice Address - Street 1:801 S. WASHINGTON ST.
Practice Address - Street 2:EDWARD HOSPITAL
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:630-527-3358
Practice Address - Fax:630-527-5018
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036115457207P00000X
IL036-115457207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine