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General NPI Number Information
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NPI Number | 1861316556
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Entity Type | Organization
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Legal Business Name | TOLEDO CLINIC INCORPORATED
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 721 ROUTE 22ND
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City | LAKE ZURICH
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State | IL
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Zip | 60047
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Country | US
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Telephone | 480-790-9352
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Fax |
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Provider Business Mailing Address
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Address Line | 4235 SECOR RD
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City | TOLEDO
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State | OH
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Zip | 43623-4299
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Country | US
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Telephone | 419-214-4214
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | AMBER D PENIX
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Credential |
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Telephone | 419-214-4214
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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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