Wendie Medina, APN
Individual provider Active NPI Rehabilitation Clinical Nurse Specialist · Chatham, IL
NPI 1922021922 · NPPES record last updated Apr 24, 2009
Key facts
- NPI
- 1922021922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rehabilitation Clinical Nurse Specialist 364SR0400X
- License
- 209005320 (IL)
- Practice address
- 512 Deer Meadow Dr
Chatham, IL 62629-5802 - Phone
- (217) 483-7864
- Fax
- (217) 483-7864
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209005320 | IL | MD | Rehabilitation Clinical Nurse Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinical Nurse Specialist | 364SR0400X | 209005320 | IL | Yes |
Addresses
Primary practice location
512 Deer Meadow Dr
Chatham, IL 62629-5802
Mailing address
512 Deer Meadow Dr
Chatham, IL 62629-5802
Phone (217) 483-7864
Other providers in Chatham, IL
- Kiley Nicole Marsaglia
- Donna G Mattera
- Joanne Mayberry
- Jennifer Lynn McCabe
- Angela Faith McCormick
- Ma Lizza Martinez Mendiola
- Micromedical Technologies, Inc
- Daj'Za Mitchell
- Amy Janine Moffat
- Miranda Joy Mogle
All providers in Chatham, IL · Rehabilitation Clinical Nurse Specialist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.