Individual
FENG WEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6447 CERMAK RD, BERWYN, IL 60402-2311
(773) 254-1400
(708) 656-0349
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 829-6842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005886
IL
363AM0700X
Medical Physician Assistant
085005886
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IL
Enumeration date
04/08/2015
Last updated
04/23/2026
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