Doctor Name: | DR. JOHN WESLEY |
NPI Number: | 1124421680 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 036094184 |
Business Practice Address: | 185 S Old Creek Rd Vernon Hills, IL - 600613134 |
Business Phone Number: | 8478218626 |
Business Fax Number: | |
Mailing Address: | 185 S Old Creek Rd, VERNON HILLS |
State: | IL |
Postal Code: | 600613134 |
Phone Number: | 8478218626 |
Fax Number: | |
NPI Enumeration Date: | 09/29/2014 |
NPI Last Update Date: | 09/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0120X |
License Number: | 036094184 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Pediatric Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |