Healthcare Provider Details

I. General information

NPI: 1184466310
Provider Name (Legal Business Name): COUNTY OF DUPAGE DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N COUNTY FARM RD
WHEATON IL
60187-3988
US

IV. Provider business mailing address

111 N COUNTY FARM RD
WHEATON IL
60187-3988
US

V. Phone/Fax

Practice location:
  • Phone: 630-221-7145
  • Fax:
Mailing address:
  • Phone: 630-221-7145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ADAMQ FORKER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 630-682-7400