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General NPI Number Information
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NPI Number | 1003978032
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Entity Type | Organization
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Legal Business Name | STRATFORD INTERNAL MEDICINE, SC
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 290 SPRINGFIELD DR SUITE 290
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2214
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Country | US
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Telephone | 630-893-9660
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Fax | 630-893-4180
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Provider Business Mailing Address
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Address Line | 290 SPRINGFIELD DR SUITE 290
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2214
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Country | US
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Telephone | 630-893-9660
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Fax | 630-893-4180
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. CHRISTINE M KENDRICK
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Credential |
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Telephone | 630-893-9660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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