Healthcare Provider Details

I. General information

NPI: 1942440086
Provider Name (Legal Business Name): WEN XUAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1098 S MILWAUKEE AVE SUITE 107A
WHEELING IL
60090-6319
US

IV. Provider business mailing address

1098 S MILWAUKEE AVE SUITE 107A
WHEELING IL
60090-6319
US

V. Phone/Fax

Practice location:
  • Phone: 847-297-6883
  • Fax: 847-297-6885
Mailing address:
  • Phone: 847-297-6883
  • Fax: 847-297-6885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198-000273
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: