Provider Demographics
NPI:1023028537
Name:MCHUGH, WENDY JEAN (OD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:JEAN
Last Name:MCHUGH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 STONEGATE RD
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5614
Mailing Address - Country:US
Mailing Address - Phone:847-658-0120
Mailing Address - Fax:847-658-0610
Practice Address - Street 1:245 STONEGATE RD
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-5614
Practice Address - Country:US
Practice Address - Phone:847-658-0120
Practice Address - Fax:847-658-0610
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009454152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5030002Medicare PIN
IL5030Medicare PIN
IL5029Medicare PIN
IL5029002Medicare PIN