Provider Demographics
NPI:1508412149
Name:WENDLING, PATRICK (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:WENDLING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14613 S STONEGATE DR
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-6783
Mailing Address - Country:US
Mailing Address - Phone:630-512-1115
Mailing Address - Fax:
Practice Address - Street 1:2424 CHARTRES ST
Practice Address - Street 2:
Practice Address - City:LA SALLE
Practice Address - State:IL
Practice Address - Zip Code:61301-1107
Practice Address - Country:US
Practice Address - Phone:815-223-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0321261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice