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General NPI Number Information
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NPI Number | 1881088557
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Entity Type | Organization
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Legal Business Name | EDWARD HEALTH VENTURES
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 120 SPALDING DR STE 307
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City | NAPERVILLE
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State | IL
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Zip | 60540-6508
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Country | US
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Telephone | 630-646-8000
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Fax | 630-646-8007
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Provider Business Mailing Address
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Address Line | 120 SPALDING DR SUITE 307
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City | NAPERVILLE
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State | IL
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Zip | 60540-6508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BILL KOTTMANN
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Credential |
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Telephone | 630-646-3950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | IL
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