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Larissa Wietlisbach

Plastic Surgery β€’ Chicago, IL

Active NPI 1982352597 Individual Practitioner Female Practitioner
Practice location in NPPES

5841 S Maryland Ave # Mc6035
Chicago, IL 606371443

Call 7737026302 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

5841 S Maryland Ave # Mc6035

Chicago, IL 606371443

Telephone 7737026302
Organization at the Same NPPES Address or Phone
University Of Chicago Facility NPI 1497907786

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Open Payments general payments, program year 2025

All general payments: $274.94 across 4 records.

By nature of payment

  • Food and Beverage: $274.94 across 4 records.

Reporting-company totals

  • PolyNovo North America LLC: $154.79 across 1 record.
  • DePuy Synthes Sales Inc.: $120.15 across 3 records.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).

Guide: How to read an Open Payments record

NPI first issued

2022

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Larissa Wietlisbach has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Larissa Wietlisbach as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Chicago and Illinois

91 active clinicians are listed under Plastic Surgery with a practice address in Chicago, IL (224 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Chicago

2.2% of these 91 clinicians have the CMS telehealth indicator.

23.1% of these 91 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2025

Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $274.94.

Manufacturer Payment Nature Product Type Amount ($)
PolyNovo North America LLC
Food and Beverage
In-kind items and services
NOVOSORB BTM General $154.79
DePuy Synthes Sales Inc.
Food and Beverage
In-kind items and services
TRUMATCH General $66.23
DePuy Synthes Sales Inc.
Food and Beverage
In-kind items and services
TRUMATCH General $40.40
DePuy Synthes Sales Inc.
Food and Beverage
In-kind items and services
TRUMATCH General $13.52

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-08-01
Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

License # reported to NPPES IL 125082534

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - PLASTIC AND RECONSTRUCTIVE SURGERY

Medicare Enrollment ID

I20230913000891

Enrollment State Jurisdiction

IL

PECOS Control ID

9234593062

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

9 listed
Dr. Lavinia Anzai , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1912430737

Doctor of Medicine (M.D.)

Courtney Brown , PA

Physician Assistant

NPI 1760143317

Physician Assistant

Sawyer Cimaroli Wimann

Student in an Organized Health Care Education/Training Program

NPI 1477136281
Dr. Ginard Henry , MD

Plastic Surgery

NPI 1932149135

Doctor of Medicine (M.D.)

Dr. Kaitlin Kavanagh , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1669091831

Doctor of Medicine (M.D.)

Martin Morris

Surgery - Plastic and Reconstructive Surgery

NPI 1710622352

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 01, 2023

Plastic Surgery (license number reported to NPPES: IL 125082534)

πŸ“
Updated Practice Location May 02, 2023

Registered at 5841 S MARYLAND AVE # MC6035, CHICAGO, IL 606371443 (Tel: 7737026302)

πŸ“
Updated Business Mailing Address May 02, 2023

Registered at 180 HARVESTER DR STE 110, BURR RIDGE, IL 605276686 (Tel: 7737021150)

βœ…
NPI Profile Active March 13, 2022

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 13, 2022

Registered at 3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 191045127 (Tel: 6109528192)

πŸ“
Business Mailing Address (Initial Record) March 13, 2022

Registered at 3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 191045127

πŸ‘€
Provider Name / Credentials (Initial Record) March 13, 2022

Recorded as LARISSA WIETLISBACH

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 13, 2022

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration March 13, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1982352597
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 13, 2022
Last Update: August 01, 2023
Sole Proprietor: No

Other Plastic Surgery Specialists in Chicago

All Plastic Surgery Specialists in Chicago

Mailing Address

180 Harvester Dr Ste 110

Burr Ridge, IL 605276686

Phone: 7737021150

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.