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General NPI Number Information
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NPI Number | 1942669478
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Entity Type | Organization
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Legal Business Name | MCHENRY PATHOLOGY ASSOCIATES, S.C
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 4201 W MEDICAL CENTER DR
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City | MCHENRY
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State | IL
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Zip | 60050-8409
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Country | US
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Telephone | 630-960-9222
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Fax |
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Provider Business Mailing Address
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Address Line | 520 E 22ND ST
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City | LOMBARD
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State | IL
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Zip | 60148-6110
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Country | US
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Telephone | 630-960-9222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WENDY L WARD
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Credential | MD
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Telephone | 815-759-4806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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