DR. JENNIFER R WISEMAN MD
NPI 1255919627
Student in an Organized Health Care Education/Training Program in Chicago, IL

Q: What is Jennifer Wiseman's NPI number?

The NPI number for Jennifer Wiseman is 1255919627. It was assigned to this individual provider in the NPPES registry on March 29, 2021.

Q: What is Jennifer Wiseman's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Wiseman was last updated on May 9, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 29, 2021PECOS Enrolled

5841 S MARYLAND AVE # MC2030, CHICAGO, IL 60637(773) 702-6222 Get Directions Write a Review

NPPES record last updated: May 9, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 9, 2025, Mar 30, 2021 (2 updates tracked since 2021).

On this page

About Dr. Jennifer R Wiseman Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JENNIFER R WISEMAN MD (NPI 1255919627) is an individual student in an organized health care education/training program in Chicago, Illinois and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in New York.

NPPES Registry Identity

NPI1255919627

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. JENNIFER R WISEMANCredential: MD

Location Address5841 S MARYLAND AVE # MC2030Chicago, IL 60637-1443

Mailing Address180 Harvester Dr Ste 110Burr Ridge, IL 60527-6686 · (773) 702-1150

Phone(773) 702-6222

Sole ProprietorNo

Enumeration DateMarch 29, 2021

Last NPPES UpdateMay 9, 20252 updates tracked since enumeration

NPPES CertifiedMay 9, 2025

✔ NPI 1255919627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 036.173088 (IL)

5841 S MARYLAND AVE # MC2030, Chicago, IL 60637

Open in Google Maps ↗

Secondary Practice Location 1

Location 1100 E 77th StNew York, NY 10075-1850 · Phone (212) 434-4833

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jennifer R Wiseman Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Leave this field empty

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VIVIEN LU MD

Student in an Organized Health Care Education/Training Program