Provider Demographics
NPI:1023200615
Name:WEDGE, FRANCES (PT)
Entity Type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:
Last Name:WEDGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 S RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MINOOKA
Mailing Address - State:IL
Mailing Address - Zip Code:60447-8810
Mailing Address - Country:US
Mailing Address - Phone:815-521-4400
Mailing Address - Fax:815-521-9709
Practice Address - Street 1:1010 S RIDGE RD
Practice Address - Street 2:
Practice Address - City:MINOOKA
Practice Address - State:IL
Practice Address - Zip Code:60447-8810
Practice Address - Country:US
Practice Address - Phone:815-521-4400
Practice Address - Fax:815-521-9709
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932202OtherBLUE CROSS BLUE SHIELD
ILK08827Medicare PIN