Individual
DR. BRANDON ALEXANDER WHEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
5841 S MARYLAND AVENUE, ROOM A700 - MC 7082, CHICAGO, IL 60637
(773) 702-1447
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-4503
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
62051
TN
207Q00000X
Family Medicine Physician
62051
TN
207R00000X
Internal Medicine Physician
Primary
125.083226
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2019
Last updated
06/05/2024
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