Healthcare Provider Details

I. General information

NPI: 1104401033
Provider Name (Legal Business Name): COMPASSIONATE MEDICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 GALWAY DR
AURORA IL
60505-1100
US

IV. Provider business mailing address

1560 GALWAY DR
AURORA IL
60505-1100
US

V. Phone/Fax

Practice location:
  • Phone: 630-569-4236
  • Fax: 331-472-2964
Mailing address:
  • Phone: 630-569-4236
  • Fax: 331-472-2964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KELLY SUZANNE DRUDI
Title or Position: APN
Credential: APN
Phone: 630-569-4236