Provider Demographics
NPI:1831431261
Name:WRENN, SEAN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MICHAEL
Last Name:WRENN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 W HARRISON ST STE 250
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3861
Mailing Address - Country:US
Mailing Address - Phone:312-942-5500
Mailing Address - Fax:
Practice Address - Street 1:1725 W HARRISON ST STE 250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3861
Practice Address - Country:US
Practice Address - Phone:312-942-5500
Practice Address - Fax:312-563-2080
Is Sole Proprietor?:No
Enumeration Date:2013-03-24
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA278947208600000X
IL036.153599208600000X
390200000X
IL036-1535992086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program