Provider Demographics
NPI:1417484171
Name:SADDLER, WENDY LASANDRA
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:LASANDRA
Last Name:SADDLER
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 1:2635 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5313
Mailing Address - Country:US
Mailing Address - Phone:708-531-1437
Mailing Address - Fax:708-356-6926
Practice Address - Street 1:2635 SOMERSET DR
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5313
Practice Address - Country:US
Practice Address - Phone:708-531-1437
Practice Address - Fax:708-356-6926
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL70133084376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide