Healthcare Provider Details

I. General information

NPI: 1598755456
Provider Name (Legal Business Name): UNIVERSITY HEAD AND NECK ASSOCIATES, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 HIGHLAND AVE STE 105
DOWNERS GROVE IL
60515-1558
US

IV. Provider business mailing address

3800 HIGHLAND AVE STE 105
DOWNERS GROVE IL
60515-1558
US

V. Phone/Fax

Practice location:
  • Phone: 630-701-3840
  • Fax: 630-574-8225
Mailing address:
  • Phone: 630-701-3840
  • Fax: 630-574-8225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number State

VIII. Authorized Official

Name: NEAL M LOFCHY
Title or Position: PRESIDENT
Credential: MD
Phone: 630-574-8222