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General NPI Number Information
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NPI Number | 1386151520
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Entity Type | Organization
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Legal Business Name | TODD HEWELL III MD LTD
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 260 W RIVER DR
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City | ST CHARLES
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State | IL
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Zip | 60174-5535
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Country | US
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Telephone | 630-377-1133
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Fax | 630-584-4099
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Provider Business Mailing Address
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Address Line | 260 W RIVER DR
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City | ST CHARLES
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State | IL
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Zip | 60174-5535
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Country | US
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Telephone | 630-377-1133
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Fax | 630-584-4099
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LAUREN HEWELL FISCHER
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Credential |
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Telephone | 630-377-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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