Provider Demographics
NPI:1386661809
Name:WEDNER, H J (MD)
Entity type:Individual
Prefix:DR
First Name:H
Middle Name:J
Last Name:WEDNER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-996-8670
Mailing Address - Fax:866-362-4984
Practice Address - Street 1:10 BARNES WEST DR
Practice Address - Street 2:DIV IM ALLERGY AND IMMUNOLOGY, STE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6287
Practice Address - Country:US
Practice Address - Phone:314-996-8670
Practice Address - Fax:866-362-4984
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3928207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200874402Medicaid
IL0352067078Medicaid
MO178010183Medicaid
MO178010183Medicare PIN