Provider Demographics
NPI:1740503754
Name:RADOUSKY, WENDIE M
Entity type:Individual
Prefix:
First Name:WENDIE
Middle Name:M
Last Name:RADOUSKY
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 1:1787 REEVES DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-2440
Mailing Address - Country:US
Mailing Address - Phone:312-880-7009
Mailing Address - Fax:
Practice Address - Street 1:399 WALL ST STE M
Practice Address - Street 2:
Practice Address - City:GLENDALE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60139-1987
Practice Address - Country:US
Practice Address - Phone:224-321-8416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator