Individual
CALVIN P WADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., FACEP
Contact information
Practice address
109 N OAK PARK AVE APT 2, OAK PARK, IL 60301-1362
(708) 524-8904
(708) 524-8907
Mailing address
109 N OAK PARK AVE APT 2, OAK PARK, IL 60301-1362
(708) 524-8904
(708) 524-8907
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-050417
IL
207P00000X
Emergency Medicine Physician
200600526
NC
207P00000X
Emergency Medicine Physician
20748
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036050417
—
IL
01
—
144XN
BCBS OF NC
NC
05
—
5906423
—
NC
Enumeration date
07/17/2006
Last updated
12/12/2008
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