Healthcare Provider Details

I. General information

NPI: 1295960664
Provider Name (Legal Business Name): WENDY ADAMS RIVARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2009
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 RAND RD
DES PLAINES IL
60016-1005
US

IV. Provider business mailing address

77 RAND RD
DES PLAINES IL
60016-1005
US

V. Phone/Fax

Practice location:
  • Phone: 847-294-5490
  • Fax:
Mailing address:
  • Phone: 847-294-5490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209007370
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number277-000086
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: