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NPI Code Detail

MEDICARE: WHEATON INTERNAL MEDICINE, LTD.

MEDICARE: WHEATON INTERNAL MEDICINE, LTD.
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
1207R00000XInternal Medicine PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1M05974OTHERILBCBS OF IL

General Provider Information

NPI Number : 1124010202
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHEATON INTERNAL MEDICINE, LTD.
Provider Business Mailing Address
First Line : 327 GUNDERSEN DR
Second Line : SUITE A
City : CAROL STREAM
State : IL
Zip : 60188-2402
Country : US
Telephone Number : 630-681-0640
Fax Number : 630-681-0659
Provider Business Practice Location Address
First Line : 327 GUNDERSEN DR
Second Line : SUITE A
City : CAROL STREAM
State : IL
Zip : 60188-2402
Country : US
Telephone Number : 630-681-0640
Fax Number : 630-681-0659
Authorized Official
Title or Position : BUSINESS OFFICE MANAGER
Name : MRS. MAMIE T. MARTIN
Credential :
Telephone Number : 630-681-0640
Provider Enumeration Date : 08/16/2005
Last Update Date : 08/22/2020

Similar Medicare Providers

1215938170 — WHEATON ORTHOPAEDICS, LTD.
Practice Location Address:
327 GUNDERSEN DR , STE A
CAROL STREAM, IL
60188-2402
Practice Phone: 630-665-9155
Practice Fax: 630-665-5557
1801897566 — DR. JENNIFER M. FELSKE D.P.M.
Practice Location Address:
327 GUNDERSEN DR , SUITE A
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1023019643 — DR. RICHARD E. ERICKSON M.D.
Practice Location Address:
327 GUNDERSEN DR , SUITE A
CAROL STREAM, IL
60188-2402
Practice Phone: 630-665-9155
Practice Fax: 630-665-5557
1316948938 — DR. STEPHEN A. BAKER M.D.
Practice Location Address:
327 GUNDERSEN DR , SUITE A
CAROL STREAM, IL
60188-2402
Practice Phone: 630-665-9155
Practice Fax: 630-665-5557
1528050218 — GREGORY T. PREVATT O,T,S.C.
Practice Location Address:
327 GUNDERSEN DR , SUITE A
CAROL STREAM, IL
60188-2402
Practice Phone: 630-665-9155
Practice Fax: 630-665-5557
1235121948 — SARAH N. BURGE P.T.
Practice Location Address:
327 GUNDERSEN DR , SUITE A
CAROL STREAM, IL
60188-2402
Practice Phone: 630-665-9155
Practice Fax: 630-665-5557

Directions to “WHEATON INTERNAL MEDICINE, LTD. ” Practice Location

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