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General NPI Number Information
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NPI Number | 1104401033
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE MEDICAL CARE LLC
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 1560 GALWAY DR
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City | AURORA
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State | IL
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Zip | 60505-1100
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Country | US
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Telephone | 630-569-4236
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Fax | 331-472-2964
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Provider Business Mailing Address
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Address Line | 1560 GALWAY DR
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City | AURORA
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State | IL
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Zip | 60505-1100
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Country | US
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Telephone | 630-569-4236
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Fax | 331-472-2964
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Authorized Official
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Title or Position | APN
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Name | KELLY SUZANNE DRUDI
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Credential | APN
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Telephone | 630-569-4236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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