Healthcare Provider Details

I. General information

NPI: 1669817367
Provider Name (Legal Business Name): BADOWSKI, DRUZAK & JENSEN MD'S 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MARTIN AVE STE 100
NAPERVILLE IL
60540-6564
US

IV. Provider business mailing address

5909 PEACHTREE DUNWOODY RD NE STE 900
ATLANTA GA
30328-5388
US

V. Phone/Fax

Practice location:
  • Phone: 630-369-7700
  • Fax: 630-369-7705
Mailing address:
  • Phone: 404-943-0205
  • Fax: 404-943-0209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LATOYSHA SHANTA DANGLER
Title or Position: LAB BILLING MANAGER
Credential:
Phone: 404-943-0205