Provider Demographics
NPI:1770200107
Name:WADLINGTON, EUKA W
Entity type:Individual
Prefix:MR
First Name:EUKA
Middle Name:W
Last Name:WADLINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6930 S JUSTINE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60636-3921
Mailing Address - Country:US
Mailing Address - Phone:773-398-3830
Mailing Address - Fax:
Practice Address - Street 1:6930 S JUSTINE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60636-3921
Practice Address - Country:US
Practice Address - Phone:773-398-3830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker