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General NPI Number Information
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NPI Number | 1770924847
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Entity Type | Organization
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Legal Business Name | CORNERSTONE MEDICAL GROUP PC
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 351 DELNOR DR
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City | GENEVA
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State | IL
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Zip | 60134-4222
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Country | US
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Telephone | 630-262-1001
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Fax | 630-262-8065
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Provider Business Mailing Address
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Address Line | 351 DELNOR DR
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City | GENEVA
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State | IL
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Zip | 60134-4222
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Country | US
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Telephone | 630-262-1001
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Fax | 630-262-8065
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. DREW PALUMBO
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Credential |
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Telephone | 630-933-5510
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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