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General NPI Number Information
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NPI Number | 1649405341
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Entity Type | Individual
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Provider Name | JAMES WADE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 08/28/2018
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Provider Practice Location Address
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Address Line | 4405 WEAVER PARKWAY
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City | WARRENVILLE
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State | IL
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Zip | 60555
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Country | US
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Telephone | 630-352-5450
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Fax |
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Provider Business Mailing Address
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Address Line | 4405 WEAVER PARKWAY
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City | WARRENVILLE
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State | IL
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Zip | 60555-3269
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Country | US
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Telephone |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 240905
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 036144128
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License Number State | IL
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