Provider Demographics
NPI:1447356126
Name:WENIG, BARRY L (MD)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:L
Last Name:WENIG
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 1:1855 W. TAYLOR ST.
Mailing Address - Street 2:DEPARTMENT OF OTOLARYNGOLOGY H&NS
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-996-6553
Mailing Address - Fax:312-996-4910
Practice Address - Street 1:1855 W. TAYLOR ST.
Practice Address - Street 2:DEPARTMENT OF OTOLARYNGOLOGY H&NS
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-996-6553
Practice Address - Fax:312-996-4910
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097695207Y00000X
IL036.077135207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1447356126Medicaid
IL036077135Medicaid
D13592Medicare UPIN