Healthcare Provider Details

I. General information

NPI: 1457559379
Provider Name (Legal Business Name): JVB MEDICAL ASSOCIATES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 S HIGHLAND AVE STE 380
LOMBARD IL
60148-5397
US

IV. Provider business mailing address

2340 S HIGHLAND AVE STE 380
LOMBARD IL
60148-5397
US

V. Phone/Fax

Practice location:
  • Phone: 630-261-8111
  • Fax:
Mailing address:
  • Phone: 630-261-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036039204
License Number StateIL

VIII. Authorized Official

Name: DR. JOHN V BELMONTE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 630-261-8111