Provider Demographics
NPI:1770558942
Name:VISNESKY, PATRICIA M (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:VISNESKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:747 N RUTLEDGE ST
Mailing Address - Street 2:BAYLIS BUILDING, SECOND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-6700
Mailing Address - Country:US
Mailing Address - Phone:217-757-7932
Mailing Address - Fax:217-757-7920
Practice Address - Street 1:747 N RUTLEDGE ST
Practice Address - Street 2:BAYLIS BUILDING, SECOND FLOOR
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-6700
Practice Address - Country:US
Practice Address - Phone:217-757-7932
Practice Address - Fax:217-757-7920
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL73805Medicare ID - Type Unspecified
E43661Medicare UPIN