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NPI Code Detail

MEDICARE: WENDY MAE FEDORONKO

MEDICARE: WENDY MAE FEDORONKO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantJ2-0000460DE

General Provider Information

NPI Number : 1811570195
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY MAE FEDORONKO
Provider Business Mailing Address
First Line : 2600 COMPASS RD
Second Line :
City : GLENVIEW
State : IL
Zip : 60026-8001
Country : US
Telephone Number : 877-787-3422
Fax Number : 847-441-4130
Provider Business Practice Location Address
First Line : 704 RIVER RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19809-2746
Country : US
Telephone Number : 302-764-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2021
Last Update Date : 05/04/2021

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Directions to “ WENDY MAE FEDORONKO ” Practice Location

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