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General NPI Number Information
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NPI Number | 1609038959
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Entity Type | Organization
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Legal Business Name | DUPAGE CONVALESCENT CENTER
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 400 N COUNTY FARM RD FINANCE DEPT.
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City | WHEATON
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State | IL
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Zip | 60187-3908
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Country | US
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Telephone | 630-784-4216
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Fax | 630-784-4212
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Provider Business Mailing Address
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Address Line | 400 N COUNTY FARM RD FINANCE DEPT.
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City | WHEATON
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State | IL
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Zip | 60187-3908
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Country | US
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Telephone | 630-784-4216
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Fax | 630-784-4212
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ELIZABETH M WELCH
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Credential | MPH,LNHA
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Telephone | 630-784-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0008201
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License Number State | IL
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