WILLOWBROOK CLINIC NPI 1740368927

NPI Information

NPI: 1740368927
Provider Name: WILLOWBROOK CLINIC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
4121 FAIRVIEW AVE STE L2
DOWNERS GROVE, IL
ZIP 60515
Phone: (630) 674-1160
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WILLOWBROOK CLINIC is a family medicine in Downers Grove, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WILLOWBROOK CLINIC NPI is 1740368927. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4121 FAIRVIEW AVE STE L2
DOWNERS GROVE, IL
ZIP 60515-275
Phone: (630) 674-1160
Fax: (866) 261-3402

The provider's authorized official is Ataullah Arain .
The authorized official title is Physician and has the following contact phone number (630) 674-1160.

The enumeration date for this NPI number is 11/2/2006 and was last updated on 12/29/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		036054825	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036054825	MEDICAID	ILLINOIS
2	602230	MEDICARE PIN	ILLINOIS
3	02201168	OTHER	ILLINOIS	BCBS OF IL
4	C39318	MEDICARE UPIN	ILLINOIS
5	=========	OTHER	ILLINOIS	TAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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