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General NPI Number Information
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NPI Number | 1003474032
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Entity Type | Organization
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Legal Business Name | COUNTY OF DUPAGE DEPARTMENT OF HEALTH
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 1111 E JACKSON ST
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City | LOMBARD
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State | IL
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Zip | 60148-3709
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Country | US
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Telephone | 630-682-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 111 N COUNTY FARM RD
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City | WHEATON
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State | IL
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Zip | 60187-3977
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ADAM FORKER
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Credential |
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Telephone | 630-682-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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