MEDICARE: ALLERGY AND ASTHMA ASSOCIATES OF DUPAGE, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	042003228	IL

General Provider Information

NPI Number	:	1134252869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY AND ASTHMA ASSOCIATES OF DUPAGE, P.C.

Provider Business Mailing Address
First Line	:	3081 HANDLEY CT
Second Line	:
City	:	LISLE
State	:	IL
Zip	:	60532-4409
Country	:	US
Telephone Number	:	630-527-7071
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 E. OGDEN AVE.
Second Line	:	SUITE 205
City	:	NAPERVILLE
State	:	IL
Zip	:	60563
Country	:	US
Telephone Number	:	630-852-4050
Fax Number	:	630-428-9764

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ASYA SEGALENE
Credential	:	M.D.
Telephone Number	:	630-852-4050

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	11/04/2015

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