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General NPI Number Information
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NPI Number | 1750331856
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Entity Type | Organization
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Legal Business Name | NAPERVILLE RADIOLOGISTS, SC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 801 S WASHINGTON ST
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City | NAPERVILLE
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State | IL
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Zip | 60540-7430
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Country | US
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Telephone | 630-321-2705
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Fax |
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Provider Business Mailing Address
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Address Line | 801 S WASHINGTON ST
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City | NAPERVILLE
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State | IL
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Zip | 60540-7430
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Country | US
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Telephone | 630-321-2705
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | JEFFREY D GIRARDOT
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Credential | MD
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Telephone | 630-321-2705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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