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General NPI Number Information
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NPI Number | 1134170541
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Entity Type | Organization
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Legal Business Name | DUPAGE OPHTHALMOLOGY
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 2500 S HIGHLAND AVENUE SUITE 110
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City | LOMBARD
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State | IL
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Zip | 60148-5381
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Country | US
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Telephone | 630-495-2220
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Fax | 630-495-2279
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Provider Business Mailing Address
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Address Line | 2500 S HIGHLAND AVE SUITE 110
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City | LOMBARD
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State | IL
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Zip | 60148-5363
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Country | US
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Telephone | 630-495-2220
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Fax | 630-495-2279
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHERIDAN LAM
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Credential | MD
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Telephone | 630-495-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | IL
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