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Individual

ELIZABETH M WENGEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
1203 W AUGUSTA BLVD STE 1, CHICAGO, IL 60642-4327
(773) 248-2255
(773) 524-2466
Mailing address
1203 W AUGUSTA BLVD STE 1, CHICAGO, IL 60642-4327
(773) 248-2255
(773) 524-2466

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209007454
IL
363LF0000X
Family Nurse Practitioner
277005219
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209007454
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277005219
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206147
MEDICARE GROUP
IL
01
F400450938
MEDICARE INDIVIDUAL
IL
Enumeration date
02/18/2009
Last updated
04/30/2026
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