| Dekalb Clinic Chartered | |
|
1850 Gateway Dr Sycamore IL 60178-3192 | |
| (815) 758-8671 | |
| (815) 758-5610 |
| Full Name | Dekalb Clinic Chartered |
|---|---|
| Speciality | Internal Medicine |
| Location | 1850 Gateway Dr, Sycamore, Illinois |
| Authorized Official Name and Position | Roger L Haab (CHAIRMAN, BOARD OF DIRECTORS) |
| Authorized Official Contact | 8157588671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dekalb Clinic Chartered 1850 Gateway Dr Sycamore IL 60178-3192 Ph: (815) 758-8671 | Dekalb Clinic Chartered 1850 Gateway Dr Sycamore IL 60178-3192 Ph: (815) 758-8671 |
| NPI Number | 1447277140 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 04/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447277140 | NPI | - | NPPES |
| 14D0415284 | Other | IL | CLIA # |
| 1421279 | Other | IL | NABP |
| 663680 | Other | IL | MEDICARE-GROUP ID |
| 148547 | Other | IL | MC INDEPENDENT LAB |
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