DUPAGE EYE ASSOCIATES S.C. NPI 1932210887

NPI Information

NPI: 1932210887
Provider Name: DUPAGE EYE ASSOCIATES S.C.

Former Legal Business Name: DUPAGE RETINA ASSOCIATES

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
3825 HIGHLAND AVE
TOWER 1 SUITE 4 J
DOWNERS GROVE, IL
ZIP 60515
Phone: (630) 971-8330
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DUPAGE EYE ASSOCIATES S.C. is a specialist in Downers Grove, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DUPAGE EYE ASSOCIATES S.C. NPI is 1932210887. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Dupage Retina Associates.

The provider's business location address is:

3825 HIGHLAND AVE
TOWER 1 SUITE 4 J
DOWNERS GROVE, IL
ZIP 60515-552
Phone: (630) 971-8330
Fax: (630) 971-2338

The provider's authorized official is Motilal Raichand .
The authorized official title is M.d. and has the following contact phone number (630) 971-8330.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 5/17/2012.

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	174400000X	Specialist		036056099	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
1	659063	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS
2	C43001	MEDICARE UPIN	ILLINOIS
3	358724500	MEDICAID	ILLINOIS
4	345601745	MEDICAID	ILLINOIS
5	205929	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS
6	H81881	MEDICARE UPIN	ILLINOIS

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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