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General NPI Number Information
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NPI Number | 1508219403
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Entity Type | Individual
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Provider Name | MEGHAN ELIZABETH WENDLAND D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/15/2016
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Last Update Date | 01/14/2017
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Provider Practice Location Address
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Address Line | 1029 E 130TH ST
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City | CHICAGO
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State | IL
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Zip | 60628-6908
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Country | US
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Telephone | 773-995-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 200 N ARLINGTON HEIGHTS RD APT 709
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-6051
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Country | US
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Telephone | 218-349-9176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.030973
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 100008
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License Number State | CA
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