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General NPI Number Information
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NPI Number | 1033214531
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Entity Type | Organization
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Legal Business Name | WILLOWBROOK FAMILY PRACTICE LTD
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 6900 S MADISON ST SUITE 101
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City | WILLOWBROOK
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State | IL
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Zip | 60527
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Country | US
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Telephone | 630-986-1177
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Fax | 630-986-1198
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Provider Business Mailing Address
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Address Line | 6900 S MADISON STREET SUITE 101
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City | WILLOWBROOK
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State | IL
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Zip | 60527
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Country | US
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Telephone | 630-986-1177
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Fax | 630-986-1198
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Authorized Official
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Title or Position | PRESIDENT
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Name | UMA TAPARIA
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Credential | MD
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Telephone | 630-986-1177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036055916
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License Number State | IL
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