| Dupage Meta-vascular Medicine Pc | |
|
245 S Gary Ave Suite 202 Bloomingdale IL 60108-2228 | |
| (630) 893-2190 | |
| (630) 307-8716 |
| Full Name | Dupage Meta-vascular Medicine Pc |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 245 S Gary Ave, Bloomingdale, Illinois |
| Authorized Official Name and Position | Barbara Mary Kosiek (RN/PRACTICE MANAGER) |
| Authorized Official Contact | 6308932190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dupage Meta-vascular Medicine Pc 245 S Gary Ave Suite 202 Bloomingdale IL 60108-2228 Ph: (630) 893-2190 | Dupage Meta-vascular Medicine Pc 245 S Gary Ave Suite 202 Bloomingdale IL 60108-2228 Ph: (630) 893-2190 |
| NPI Number | 1366581811 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 02/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366581811 | NPI | - | NPPES |
| 2232209 | Other | IL | BLUE SHIELD NUMBER |
| 1366581811 | Other | IL | GROUP NPI |
| P00843099 | Other | IL | RAIL ROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 036047587 (Illinois) | Primary |
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