| Dupage Health And Physical Therapy Center Sc | |
|
1795 S Washington St Ste 109 Naperville IL 60565-2058 | |
| (630) 961-0259 | |
| (630) 961-2406 |
| Full Name | Dupage Health And Physical Therapy Center Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1795 S Washington St Ste 109, Naperville, Illinois |
| Authorized Official Name and Position | Richard R. Fay (OWNER) |
| Authorized Official Contact | 6309610259 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 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: (630) 961-0259 |
| NPI Number | 1164586798 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 03/19/2015 |
| Medicare PECOS PAC ID | 6800999798 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1669570677 PECOS PAC ID: 6901909894 Enrollment ID: I20070314000203 |
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