Provider Demographics
NPI:1275192726
Name:WEHLING, PAIGE
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:WEHLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25007 ROUTE 2 N
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:61257-9744
Mailing Address - Country:US
Mailing Address - Phone:708-935-5260
Mailing Address - Fax:
Practice Address - Street 1:3451 MORTON DR
Practice Address - Street 2:
Practice Address - City:EAST MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61244-1921
Practice Address - Country:US
Practice Address - Phone:309-755-7621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-09
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
IL242.004884235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist