Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036-145898 | IL |
N | 111NI0900X | Internist | 036-145898 | IL |
Y | 207RR0500X | Rheumatology | 036145898 | IL |
NPI | 1043553704 |
---|---|
Provider Name | Wenlu Wendy Xiong |
First Address | Chicago, IL 60612-4861 |
Second Address | Chicago, IL 60612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2013 |
Last Update Date | 04/05/2021 |