Dupage Health And Physical Therapy Center Sc | |
1795 S Washington St Ste 109 Naperville IL 60565-2058 | |
(331) 401-5900 | |
(331) 215-7318 |
Full Name | Dupage Health And Physical Therapy Center Sc |
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Speciality | Clinic/Center |
Location | 1795 S Washington St Ste 109, Naperville, Illinois |
Authorized Official Name and Position | Richard R. Fay (OWNER) |
Authorized Official Contact | 3314015900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dupage Health And Physical Therapy Center Sc 1795 S Washington St Ste 109 Naperville IL 60565-2058 Ph: (630) 961-0259 | Dupage Health And Physical Therapy Center Sc 1795 S Washington St Ste 109 Naperville IL 60565-2058 Ph: (331) 401-5900 |
NPI Number | 1164586798 |
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Provider Enumeration Date | 12/20/2006 |
Last Update Date | 10/14/2024 |
Medicare PECOS PAC ID | 6800999798 |
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Medicare Enrollment ID | O20070314000209 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164586798 | NPI | - | NPPES |
02232874 | Other | IL | BLUE CROSSBLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 042-618902 (Illinois) | Primary |
Provider Name | Richard R Fay |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1669570677 PECOS PAC ID: 6901909894 Enrollment ID: I20070314000203 |
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