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General NPI Number Information
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NPI Number | 1376896076
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Entity Type | Organization
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Legal Business Name | AMEY J MUZUMDAR DC SC
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 850 N CASS AVE SUITE 101
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City | WESTMONT
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State | IL
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Zip | 60559-1394
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Country | US
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Telephone | 630-567-1007
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Fax | 630-325-8220
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Provider Business Mailing Address
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Address Line | 1303 MIDWEST CLUB PKWY
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City | OAK BROOK
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State | IL
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Zip | 60523-2519
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Country | US
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Telephone | 630-567-1007
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Fax | 630-325-8220
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMEY J MUZUMDAR
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Credential | D.C.
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Telephone | 630-567-1007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 042620047
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License Number State | IL
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