Provider Demographics
NPI:1477626745
Name:WENDT, JAMES BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRIAN
Last Name:WENDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4 CRESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1136
Mailing Address - Country:US
Mailing Address - Phone:603-252-0199
Mailing Address - Fax:605-333-5311
Practice Address - Street 1:2501 W 22ND ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1305
Practice Address - Country:US
Practice Address - Phone:605-336-3230
Practice Address - Fax:605-333-5311
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH12685207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH12585OtherSTATE LICENSE