MEDICARE: UNIVERSITY HEAD AND NECK ASSOCIATES, 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	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician
2	207Y00000X	Otolaryngology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01619292	OTHER		BCBSIL GROUP NUMBER
2	01619292	OTHER	IL	BLUE SHIELD PPO

General Provider Information

NPI Number	:	1598755456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY HEAD AND NECK ASSOCIATES, SC

Provider Business Mailing Address
First Line	:	3800 HIGHLAND AVE STE 105
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1558
Country	:	US
Telephone Number	:	630-701-3840
Fax Number	:	630-574-8225

Provider Business Practice Location Address
First Line	:	3800 HIGHLAND AVE STE 105
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1558
Country	:	US
Telephone Number	:	630-701-3840
Fax Number	:	630-574-8225

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NEAL M LOFCHY
Credential	:	MD
Telephone Number	:	630-574-8222

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	09/08/2020

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Directions to “UNIVERSITY HEAD AND NECK ASSOCIATES, SC ” Practice Location

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