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General NPI Number Information
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NPI Number | 1780863811
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Entity Type | Organization
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Legal Business Name | BERWYN TOWNSHIP PUBLIC HEALTH DISTRICT
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 6600 W. 26TH STREET
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City | BERWYN
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State | IL
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Zip | 60402-2652
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Country | US
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Telephone | 708-788-6600
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Fax | 708-788-0432
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Provider Business Mailing Address
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Address Line | 6600 W. 26TH STREET
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City | BERWYN
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State | IL
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Zip | 60402-2652
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Country | US
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Telephone | 708-788-6600
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Fax | 708-788-0432
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Authorized Official
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Title or Position | PRESIDENT, BERWYN TOWNSHIP PUBLIC H
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Name | MRS. ELIZABETH ANN PECHOUS
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Credential |
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Telephone | 708-788-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 036068028
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 14D0993141
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License Number State | IL
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