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General NPI Number Information
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NPI Number | 1952524431
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Entity Type | Organization
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Legal Business Name | THE DISCOVERY CLINIC, INC.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 1306 WAUKEGAN RD #210
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City | GLENVIEW
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State | IL
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Zip | 60025-3072
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Country | US
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Telephone | 847-901-0909
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Fax | 847-901-0910
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Provider Business Mailing Address
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Address Line | 1306 WAUKEGAN RD #210
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City | GLENVIEW
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State | IL
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Zip | 60025-3072
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Country | US
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Telephone | 847-901-0909
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Fax | 847-901-0910
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Authorized Official
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Title or Position | CO-PRESIDENT
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Name | MS. ANN R RICHMAN
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Credential | MA
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Telephone | 847-901-0909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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