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General NPI Number Information
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NPI Number | 1205082427
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Entity Type | Organization
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Legal Business Name | PLAINFIELD HEALTHCARE ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/08/2008
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 1012 95TH ST SUITE #8
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City | NAPERVILLE
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State | IL
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Zip | 60564-5041
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Country | US
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Telephone | 630-778-9444
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Fax | 630-778-9424
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Provider Business Mailing Address
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Address Line | 2100 MANCHESTER ROAD SUITE 615 BUILDING A
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City | WHEATON
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State | IL
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Zip | 60187
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Country | US
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Telephone | 630-384-1256
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Fax | 630-260-4120
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Authorized Official
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Title or Position | PROJECT MANAGER
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Name | MS. EVA BONILLA
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Credential |
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Telephone | 630-384-1256
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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 |
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License Number State |
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