NAPERBROOK MEDICAL CENTER NPI 1184801706

NPI Information

NPI: 1184801706
Provider Name: NAPERBROOK MEDICAL CENTER
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 14D0911713

Address:
686 W BOUGHTON RD
BOLINGBROOK, IL
ZIP 60440
Phone: (630) 378-1234
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NAPERBROOK MEDICAL CENTER is a primary care clinic center in Bolingbrook, IL. NAPERBROOK MEDICAL CENTER NPI is 1184801706. The provider is registered as an organization entity type.

The provider's business location address is:

686 W BOUGHTON RD
BOLINGBROOK, IL
ZIP 60440-520
Phone: (630) 378-1234
Fax: (630) 378-1155

The provider's authorized official is Meher Bala Medavaram .
The authorized official title is President and has the following contact phone number (630) 378-1234.

The CLIA number assigned to this NPI record is 14D0911713 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/25/2008 and was last updated on 1/25/2008.

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	261QP2300X	Clinic/Center	Primary Care	042-007177	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	G41052	MEDICARE UPIN	ILLINOIS
2	334770	MEDICARE PIN	ILLINOIS
3	09921620	OTHER	ILLINOIS	BLUECROSS BLUESHIELD

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: 11/14/2023

NPI Synchronization or Removal

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