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General NPI Number Information
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NPI Number | 1619977006
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Entity Type | Organization
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Legal Business Name | J.L. WU, D.P.M., P.C.
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 108 W BARTLETT AVE
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City | BARTLETT
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State | IL
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Zip | 60103-4235
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Country | US
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Telephone | 630-483-2212
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Fax | 630-483-2237
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Provider Business Mailing Address
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Address Line | 108 W BARTLETT AVE
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City | BARTLETT
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State | IL
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Zip | 60103-4235
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Country | US
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Telephone | 630-483-2212
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Fax | 630-483-2237
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHNNY L WU
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Credential | D.P.M.
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Telephone | 630-483-2212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State | IL
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