Healthcare Provider Details

I. General information

NPI: 1487627154
Provider Name (Legal Business Name): NORTH AMERICAN EMERGENCY MEDICAL CENTER,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1254 OGDEN AVE
DOWNERS GROVE IL
60515-2740
US

IV. Provider business mailing address

1254 OGDEN AVE
DOWNERS GROVE IL
60515-2740
US

V. Phone/Fax

Practice location:
  • Phone: 630-963-6912
  • Fax: 630-963-1499
Mailing address:
  • Phone: 630-963-6912
  • Fax: 630-963-1499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0590240001
License Number StateIL

VIII. Authorized Official

Name: DR. SUBHASH RAO
Title or Position: PRESIDENT
Credential: MD
Phone: 630-963-6912