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General NPI Number Information
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NPI Number | 1205374717
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Entity Type | Organization
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Legal Business Name | WHEATON ORTHOPAEDICS, LTD
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 1971 GOWDEY RD SUITE 207
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City | NAPERVILLE
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State | IL
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Zip | 60563-4232
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Country | US
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Telephone | 630-665-9155
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Fax | 630-665-9770
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Provider Business Mailing Address
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Address Line | 327 GUNDERSEN DR SUITE A
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City | CAROL STREAM
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State | IL
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Zip | 60188-2402
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Country | US
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Telephone | 630-665-9155
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Fax | 630-665-9770
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. STEPHEN A BAKER
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Credential | M.D.
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Telephone | 630-665-9155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 042001705
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License Number State | IL
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