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General NPI Number Information
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NPI Number | 1649026196
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Entity Type | Organization
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Legal Business Name | DANADA VEIN CARE SC
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 180 DANADA SQ W
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City | WHEATON
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State | IL
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Zip | 60189-2041
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Country | US
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Telephone | 630-474-2600
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Fax | 630-474-2601
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Provider Business Mailing Address
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Address Line | 180 DANADA SQ W
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City | WHEATON
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State | IL
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Zip | 60189-2041
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Country | US
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Telephone | 630-474-2600
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Fax | 630-474-2601
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Authorized Official
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Title or Position | OWNER
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Name | SEAN MCWILLIAMS
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Credential | MD
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Telephone | 630-474-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number |
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License Number State |
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