Healthcare Provider Details

I. General information

NPI: 1912163130
Provider Name (Legal Business Name): HEIDI WEHLUS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 BUSCH PKWY STE 110
BUFFALO GROVE IL
60089-4541
US

IV. Provider business mailing address

1450 BUSCH PKWY STE 110
BUFFALO GROVE IL
60089-4541
US

V. Phone/Fax

Practice location:
  • Phone: 847-495-2311
  • Fax: 833-455-7658
Mailing address:
  • Phone: 847-495-2311
  • Fax: 833-455-7658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036-122890
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: