MEDICARE: WENDY L STERNBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036088450	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01623192	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1114053980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY L STERNBERG MD

Provider Business Mailing Address
First Line	:	181 W MADISON ST
Second Line	:	SUITE 3825
City	:	CHICAGO
State	:	IL
Zip	:	60602-4510
Country	:	US
Telephone Number	:	312-219-2230
Fax Number	:	312-219-2239

Provider Business Practice Location Address
First Line	:	181 W MADISON ST
Second Line	:	SUITE 3825
City	:	CHICAGO
State	:	IL
Zip	:	60602-4510
Country	:	US
Telephone Number	:	312-219-2230
Fax Number	:	312-219-2239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	03/11/2013

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