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General NPI Number Information
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NPI Number | 1871689208
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Entity Type | Organization
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Legal Business Name | NOVA MEDICO S.C.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 1480 RENAISSANCE DR STE 211
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City | PARK RIDGE
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State | IL
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Zip | 60068-1353
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Country | US
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Telephone | 847-296-6161
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Fax | 847-296-6262
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Provider Business Mailing Address
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Address Line | PO BOX 7412492
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City | CHICAGO
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State | IL
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Zip | 60674-2492
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Country | US
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Telephone | 847-296-6161
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Fax | 847-296-6262
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Authorized Official
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Title or Position | DIRECTOR OF RCM
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Name | KIMBERLY MILLER
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Credential |
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Telephone | 248-331-7908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 036092302
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License Number State | IL
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