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General NPI Number Information
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NPI Number | 1912502071
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Entity Type | Organization
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Legal Business Name | HEMATOLOGY CONNECT LLC
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 444 E ROOSEVELT RD STE 277
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City | LOMBARD
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State | IL
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Zip | 60148-4630
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Country | US
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Telephone | 630-785-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 444 E ROOSEVELT RD STE 277
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City | LOMBARD
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State | IL
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Zip | 60148-4630
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Country | US
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Telephone | 630-785-3000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREA DEAN
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Credential | MD
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Telephone | 313-399-4635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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