Provider Demographics
NPI:1912295643
Name:HUSH, WENDY LYNN (DT)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:LYNN
Last Name:HUSH
Suffix:
Gender:F
Credentials:DT
Other - Prefix:MISS
Other - First Name:WENDY
Other - Middle Name:LYNN
Other - Last Name:MARTINKUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:445 W FULLERTON PKWY
Mailing Address - Street 2:UNIT 3E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5185
Mailing Address - Country:US
Mailing Address - Phone:773-307-3486
Mailing Address - Fax:
Practice Address - Street 1:445 W FULLERTON PKWY
Practice Address - Street 2:UNIT 3E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-5185
Practice Address - Country:US
Practice Address - Phone:773-307-3486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist