Provider Demographics
NPI:1447200563
Name:KISIELIUS, PETRAS V (MD)
Entity Type:Individual
Prefix:
First Name:PETRAS
Middle Name:V
Last Name:KISIELIUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4201 WINFIELD RD FL 4
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-4025
Mailing Address - Country:US
Mailing Address - Phone:331-221-6377
Mailing Address - Fax:331-221-2357
Practice Address - Street 1:1200 S YORK ST STE 2000
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5634
Practice Address - Country:US
Practice Address - Phone:331-221-9004
Practice Address - Fax:331-221-2748
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-06-22
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Provider Licenses
StateLicense IDTaxonomies
IL036068731208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology