THOMAS PETER WENTLAND

ROCKFORD, IL
NPI1750307005
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  036092325)
Additional Taxonomies207Q00000X Family Medicine
(Licence: IL  036092325)
Enumeration Date2006-07-13
Last Update Date2018-05-31
Business Address
THOMAS PETER WENTLAND MD
698 FEATHERSTONE RD
ROCKFORD, IL 61107
Phone number: 815-398-3277
Mailing Address
THOMAS PETER WENTLAND MD
200 CORPORATE BLVD
LAFAYETTE, LA 70508-3870
Phone number: 800-893-9698