Provider Demographics
NPI:1033391610
Name:ABOURJEILY, WENDY (DO)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:ABOURJEILY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11320 SAYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-9321
Mailing Address - Country:US
Mailing Address - Phone:440-724-7331
Mailing Address - Fax:440-543-3837
Practice Address - Street 1:11320 SAYBROOK LN
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-9321
Practice Address - Country:US
Practice Address - Phone:440-724-7331
Practice Address - Fax:440-543-3837
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.004679207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine