Larissa Wietlisbach, - Medicare Plastic Surgery in Chicago, IL

Larissa Wietlisbach, is a medicare enrolled "Plastic Surgery" physician in Chicago, Illinois. Her current practice location is 5841 S Maryland Ave # Mc6035, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at (773) 702-6302.

Larissa Wietlisbach is licensed to practice in Illinois (license number 125082534) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982352597.

Contact Information

Larissa Wietlisbach,
5841 S Maryland Ave # Mc6035,
Chicago, IL 60637-1443
(773) 702-6302
Not Available



Physician's Profile

Full NameLarissa Wietlisbach
GenderFemale
SpecialityPlastic Surgery
Location5841 S Maryland Ave # Mc6035, Chicago, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1982352597
  • Provider Enumeration Date: 03/13/2022
  • Last Update Date: 08/01/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9234593062
  • Enrollment ID: I20230913000891

Medical Identifiers

Medical identifiers for Larissa Wietlisbach such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1982352597NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208200000XPlastic Surgery 125082534 (Illinois)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larissa Wietlisbach is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Larissa Wietlisbach,
180 Harvester Dr Ste 110,
Burr Ridge, IL 60527-6686

Ph: (773) 702-1150
Larissa Wietlisbach,
5841 S Maryland Ave # Mc6035,
Chicago, IL 60637-1443

Ph: (773) 702-6302

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› Verified 7 days ago


Plastic Surgery Doctors in Chicago, IL

Parit A Patel, MD
Plastic Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 737 N Michigan Ave Ste 1820, Chicago, IL 60611
Phone: 312-819-5338    Fax: 312-819-5337
Akira Yamada,
Plastic Surgery
Medicare: Medicare Enrolled
Practice Location: 225 E Chicago Ave, Division Of Plastic Surgery, Chicago, IL 60611
Phone: 312-227-6258    Fax: 312-227-9408
Lyndsay Ann Kandi, MD
Plastic Surgery
Medicare: Medicare Enrolled
Practice Location: 5841 S Maryland Ave # Mc6035, Chicago, IL 60637
Phone: 773-702-6302    Fax: 773-702-1634
Dr. Diane L Gerber, MD
Plastic Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 250 E Pearson St, #2803, Chicago, IL 60611
Phone: 312-280-8707    
Stephanie Bond, MD
Plastic Surgery
Medicare: Medicare Enrolled
Practice Location: 5841 S Maryland Ave # Mc6035, Chicago, IL 60637
Phone: 773-795-1240    
Anne Huang, MD
Plastic Surgery
Medicare: Medicare Enrolled
Practice Location: 5841 S Maryland Ave # Mc6035, Chicago, IL 60637
Phone: 773-795-1240    Fax: 773-702-1634
Maria Alexandra Artunduaga, M.D.
Plastic Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 5841 S Maryland Ave, Mc 6035, Chicago, IL 60637
Phone: 773-795-1240    

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