Dr. Andrew Vernon Wahl
Podiatrist
1960 Essington Rd Suite 103
Joliet
, Illinois 60435-1617
Dr. Andrew Vernon Wahl
Podiatrist
1960 Essington Rd Suite 103
Joliet
, Illinois 60435-1617
(815) 436-3555
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About
Features
Specialties
- Podiatrist
Languages spoken
- English
Location
First Address
- Dr. Andrew Vernon Wahl
- 1960 Essington Rd Suite 103
- Joliet, IL
- Zip : 60435-1617
- Phone : (815) 436-3555
Second Address
- Dr. Andrew Vernon Wahl
- 1960 Essington Rd Suite 103
- Joliet, IL
- Zip : 60435-1617
- Phone : (815) 436-3555
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 016-004460 | IL |
| Y | 222Z00000X | Podiatrist | 016-004460 | IL |
National Provider Identifier
| NPI | 1053478479 |
|---|---|
| Provider Name | Dr. Andrew Vernon Wahl |
| First Address | Joliet, IL 60435-1617 |
| Second Address | Joliet, IL 60435-1617 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/01/2007 |
| Last Update Date | 20/11/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U12226 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.