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General NPI Number Information
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NPI Number | 1861804015
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Entity Type | Organization
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Legal Business Name | WOODWARD COMPREHENSIVE MEDICAL
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Dates
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Enumeration Date | 05/22/2014
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Last Update Date | 05/22/2014
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Provider Practice Location Address
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Address Line | 2005 W. 75TH STREET
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City | WOODRIDGE
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State | IL
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Zip | 60517-2308
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Country | US
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Telephone | 630-985-4700
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Fax | 630-985-4523
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Provider Business Mailing Address
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Address Line | 2005 W. 75TH STREET
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City | WOODRIDGE
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State | IL
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Zip | 60517-2308
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Country | US
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Telephone | 630-985-4700
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Fax | 630-985-4523
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM C. CAMPBELL
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Credential | D.O.
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Telephone | 630-985-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 036119743
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License Number State | IL
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