Individual
DEBORAH L. WENNINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1259 RICKERT DR, SUITE 101, NAPERVILLE, IL 60540-8902
(630) 968-1881
(630) 968-3762
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
(630) 245-9098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001702
IL
363AS0400X
Surgical Physician Assistant
085001702
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085001702
—
IL
01
—
P000324870
RAILROAD MEDICARE
IL
Enumeration date
09/27/2005
Last updated
07/28/2023
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