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General NPI Number Information
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NPI Number | 1487876686
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Entity Type | Organization
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Legal Business Name | DUPAGE NEUROSURGERY SC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 04/09/2009
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Provider Practice Location Address
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Address Line | 2001 N GARY AVENUE SUITE 220
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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 | 630-858-5400
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Fax | 630-858-4950
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Provider Business Mailing Address
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Address Line | 2001 N GARY AVE
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City | WHEATON
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State | IL
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Zip | 60187-3055
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Country | US
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Telephone | 630-858-5400
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Fax | 630-858-4950
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LISA PICHA
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Credential |
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Telephone | 630-858-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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