Larissa Wietlisbach
Larissa Wietlisbach is a Plastic Surgery Physician in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2022.
- Licensed in
- IL
- In the registry since
- 2022
Practice location Address checks out
5841 S Maryland Ave # MC6035Chicago, IL 60637-1443
Phone: (773) 702-6302
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Specialties & licences
| Plastic Surgery Physician (primary) | Taxonomy 208200000X · Licence 125082534 (IL) |
|---|
Record details
| NPI number | 1982352597 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | March 13, 2022 |
| Last updated in NPPES | August 1, 2023 |
| Certification date | August 1, 2023 |
| Mailing address | 180 Harvester Dr Ste 110, Burr Ridge, IL 60527-6686 |
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