MEDICARE: DR. WENDY LIU M.D.

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	207L00000X	Anesthesiology Physician	036.141253	IL

General Provider Information

NPI Number	:	1386062552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDY LIU M.D.

Provider Business Mailing Address
First Line	:	355 E OHIO ST UNIT 2601
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5645
Country	:	US
Telephone Number	:	305-586-9330
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 E OHIO ST UNIT 2601
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5645
Country	:	US
Telephone Number	:	305-586-9330
Fax Number	:

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

Provider Enumeration Date	:	04/03/2014
Last Update Date	:	03/05/2021

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