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General NPI Number Information
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NPI Number | 1518153600
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Entity Type | Organization
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Legal Business Name | VISITING DOCTORS NETWORK LLC
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 1 TIFFANY PT SUITE G-18
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2936
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Country | US
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Telephone | 630-980-8140
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Fax | 630-980-8148
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Provider Business Mailing Address
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Address Line | 1 TIFFANY PT SUITE G-18
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2936
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Country | US
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Telephone | 630-980-8140
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Fax | 630-980-8148
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | ANNALYN F HIBOGAMBOA
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Credential |
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Telephone | 630-980-8410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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