Basic Information
| Provider Information | |||||||||
| NPI: | 1992793822 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GIESER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2015 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WHEATON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601873152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306688250 | ||||||||
| FaxNumber: | 6306688916 | ||||||||
| Practice Location | |||||||||
| Address1: | 2015 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WHEATON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601873152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306688250 | ||||||||
| FaxNumber: | 6306688916 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2005 | ||||||||
| LastUpdateDate: | 03/19/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 036-052908 | IL | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 188012224 | 01 | IL | RR MEDICARE | OTHER | 036052908 | 05 | IL | MEDICAID |