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General NPI Number Information
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NPI Number | 1093460693
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Entity Type | Organization
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Legal Business Name | DUPAGE COUNTY DIAGNOSTICS LLC
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 1315 BUTTERFIELD RD STE 200
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5602
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Country | US
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Telephone | 630-234-9407
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Fax | 847-241-2881
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Provider Business Mailing Address
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Address Line | 1315 BUTTERFIELD RD STE 200
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5602
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Country | US
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Telephone | 630-234-9407
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Fax | 847-241-2881
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARCELA CORRALES
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Credential |
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Telephone | 630-234-9407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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