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General NPI Number Information
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NPI Number | 1831752559
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Entity Type | Organization
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Legal Business Name | SUPERIOR NEUROLOGY AND EMG, PLLC
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 04/18/2019
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Provider Practice Location Address
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Address Line | 5601 S COUNTY LINE RD
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City | HINSDALE
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State | IL
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Zip | 60521-4875
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Country | US
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Telephone | 630-797-8600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 399
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City | HINSDALE
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State | IL
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Zip | 60522-0399
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Country | US
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Telephone | 630-797-8600
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LINDA IFTIKHAR
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Credential |
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Telephone | 708-783-0345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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