Provider Demographics
NPI:1336654748
Name:FOLEY, WENDY (FNP-C)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:FOLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 SEDGEGRASS DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-2035
Mailing Address - Country:US
Mailing Address - Phone:217-621-3488
Mailing Address - Fax:
Practice Address - Street 1:1806 WOODFIELD DR
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-9505
Practice Address - Country:US
Practice Address - Phone:708-405-9434
Practice Address - Fax:949-404-6641
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.016962363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care