MEDICARE: DUPAGE GYNECOLOGY, SC

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	207VG0400X	Gynecology Physician		IL

General Provider Information

NPI Number	:	1316157498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUPAGE GYNECOLOGY, SC

Provider Business Mailing Address
First Line	:	397 S SCHMALE RD
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-2756
Country	:	US
Telephone Number	:	630-653-4240
Fax Number	:	630-225-4033

Provider Business Practice Location Address
First Line	:	397 S SCHMALE RD
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-2756
Country	:	US
Telephone Number	:	630-653-4240
Fax Number	:	630-225-4033

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL I HUSSEY
Credential	:	MD
Telephone Number	:	630-225-4040

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	08/22/2020

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Practice Location Address:

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