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General NPI Number Information
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NPI Number | 1083745251
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Entity Type | Organization
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Legal Business Name | MIDWEST GASTROENTEROLOGY ASSOCIATES LTD
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 17 W 755 BUTTERFIELD RD SUITE 101
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181
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Country | US
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Telephone | 630-827-0100
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Fax | 630-827-0103
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Provider Business Mailing Address
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Address Line | 17 W 755 BUTTERFIELD RD SUITE 101
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181
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Country | US
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Telephone | 630-827-0100
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Fax | 630-827-0103
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DHRUVA TILWALLI
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Credential | MD
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Telephone | 630-827-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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