Organization Name: | DUPAGE IMMEDIATE CARE, LTD |
NPI Number: | 1114262326 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | IBRAHIM A MAJZOUB (CEO / PRESIDENT) |
Mailing Address: | 1s210 Summit Ave Oakbrook Terrace |
State: | IL US |
Postal Code: | 601813933 |
Phone Number: | 6302826002 |
Fax Number: | 6302827322 |
NPI Enumeration Date: | 11/29/2012 |
NPI Last Update Date: | 08/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | 68548217 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |