Wayne, Audrey L

Wayne, Audrey L is an individual health care provider with primary practice located at 12 Salt Creek Lane Ste 100, Hinsdale IL 60521. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Wayne, Audrey L can be contacted via phone (630) 654-4551.

Contact Information

Primary practice address
12 Salt Creek Lane Ste 100 Hinsdale IL 60521
Phone: (630) 654-4551
Fax: (630) 654-0498
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 36060060 Illinois

Profile Details

NPI number 1417051509
LBN Legal business name Wayne, Audrey L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417051509 NPPES
Illinois Other 0220130801 BLUE CROSS BLUE SHIELD
Illinois Other 36060060 BLUE CROSS BLUE SHIELD

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