Wanda Pettye, is a
Licensed Practical Nurse based in Park Forest, Illinois. Wanda Pettye is licensed to practice in Illinois (license number 043071327) and her current practice location is
3618 Western Ave, Park Forest, Illinois. She can be reached at her office (for appointments etc.) via phone at
(708) 228-0999.
NPI number for Wanda Pettye is 1780998674 and her current mailing address is 3618 Western Ave, Park Forest, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1780998674.
Provider's Profile
Full Name | Wanda Pettye |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 3618 Western Ave, Park Forest, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1780998674
- Provider Enumeration Date: 08/03/2010
- Last Update Date: 08/03/2010
Medical Identifiers
Medical identifiers for Wanda Pettye such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1780998674 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 043071327 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wanda Pettye is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Wanda Pettye, 3618 Western Ave, Park Forest, IL 60466-2126 Ph: (708) 228-0999 | Wanda Pettye, 3618 Western Ave, Park Forest, IL 60466-2126 Ph: (708) 228-0999 |
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