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General NPI Number Information
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NPI Number | 1578538492
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Entity Type | Individual
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Provider Name | WENDY J MARSHALL MD, FACS
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Gender | Female
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 300 BARNEY DR SUITE A
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City | JOLIET
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State | IL
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Zip | 60435-5296
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Country | US
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Telephone | 815-744-0330
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Fax | 815-744-0445
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Provider Business Mailing Address
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Address Line | 300 BARNEY DR SUITE A
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City | JOLIET
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State | IL
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Zip | 60435-5296
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Country | US
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Telephone | 815-744-0330
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Fax | 815-744-0445
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036075261
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License Number State | IL
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