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General NPI Number Information
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NPI Number | 1750610903
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Entity Type | Organization
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Legal Business Name | PROVENA HOSPITALS
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 1325 N HIGHLAND AVE
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City | AURORA
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State | IL
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Zip | 60506-1449
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Country | US
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Telephone | 630-859-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 N HIGHLAND AVE
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City | AURORA
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State | IL
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Zip | 60506-1449
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Country | US
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Telephone | 630-859-2222
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | DEBORAH SCHIMEROWSKI
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Credential |
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Telephone | 630-801-2729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number |
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License Number State |
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