Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 336.108017 | IL |
NPI | 1083906838 |
---|---|
Provider Name | Dr. Michael Wemhoff |
First Address | Downers Grove, IL 60515-1562 |
Second Address | Maywood, IL 60153-3328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2011 |
Last Update Date | 18/11/2021 |