Organization Name: | INTEGRATED SURGICAL SPECIALISTS, LLC |
NPI Number: | 1487990420 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN M WIELAND (PARTNER) |
Mailing Address: | 1505 Eastland Dr Suite 2300 Bloomington |
State: | IL US |
Postal Code: | 617013534 |
Phone Number: | 3096629022 |
Fax Number: | 3096622091 |
NPI Enumeration Date: | 12/19/2012 |
NPI Last Update Date: | 04/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036078215 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |