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General NPI Number Information
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NPI Number | 1174879340
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Entity Type | Organization
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Legal Business Name | WHEATON MEDICAL SC
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 640 E SAINT CHARLES RD STE 204, 205, 206
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City | CAROL STREAM
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State | IL
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Zip | 60188-3083
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Country | US
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Telephone | 630-480-7155
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Fax | 630-447-9942
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Provider Business Mailing Address
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Address Line | 640 E SAINT CHARLES RD STE 204, 205, 206
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City | CAROL STREAM
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State | IL
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Zip | 60188-3083
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Country | US
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Telephone | 630-480-7155
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Fax | 630-447-9942
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | STELLA ZAIMI
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Credential |
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Telephone | 630-677-3742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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