Healthcare Provider Details

I. General information

NPI: 1568564615
Provider Name (Legal Business Name): JOAN T. CARDONE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 05/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 PLAINFIELD RD SUITE C
WILLOWBROOK IL
60527-7600
US

IV. Provider business mailing address

545 PLAINFIELD RD STE C
WILLOWBROOK IL
60527-7601
US

V. Phone/Fax

Practice location:
  • Phone: 630-654-2229
  • Fax: 630-655-3270
Mailing address:
  • Phone: 630-654-2229
  • Fax: 630-655-3850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036-091264
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: