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General NPI Number Information
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NPI Number | 1215143250
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Entity Type | Organization
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Legal Business Name | PAULINE K. WIENER, M.D., S.C.
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | 27W350 HIGH LAKE RD
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City | WINFIELD
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State | IL
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Zip | 60190-1262
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Country | US
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Telephone | 630-682-2746
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Fax | 630-681-8657
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Provider Business Mailing Address
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Address Line | 1N681 BOB O LINK DR
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City | WINFIELD
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State | IL
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Zip | 60190-2326
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Country | US
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Telephone | 630-682-2746
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Fax | 630-681-8657
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAULINE K WIENER
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Credential | M.D.
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Telephone | 630-682-2746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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