Provider Demographics
NPI:1194175455
Name:WEHDE, CHAPIN (ATC)
Entity type:Individual
Prefix:
First Name:CHAPIN
Middle Name:
Last Name:WEHDE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2851
Mailing Address - Country:US
Mailing Address - Phone:630-335-7962
Mailing Address - Fax:
Practice Address - Street 1:5700 COLLEGE RD
Practice Address - Street 2:ATHLETICS
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-2851
Practice Address - Country:US
Practice Address - Phone:630-335-7962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096003199390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program