D NPI 1902152846

NPI Information

NPI: 1902152846
Provider Name: D
Classification: Clinic/Center - 261QP2400X
Entity Type: Organization

Specialization: Prison Health

Address:
3825 CAMPTON HILLS DR
ST CHARLES, IL
ZIP 60175
Phone: (630) 584-0506
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D is a prison health clinic center in St Charles, IL. D NPI is 1902152846. The provider is registered as an organization entity type.

The provider's business location address is:

3825 CAMPTON HILLS DR
ST CHARLES, IL
ZIP 60175-062
Phone: (630) 584-0506

The provider's authorized official is Stella Munoz .
The authorized official title is Nurse Practitioner and has the following contact phone number (630) 279-4861.

The CLIA number assigned to this NPI record is 14D0869050 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/30/2012 and was last updated on 7/30/2012.

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	261QP2400X	Clinic/Center	Prison Health	209.004846	ILLINOIS	Yes

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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