| Organization Name: | WOODWARD MEDICAL CENTER, LTD |
| NPI Number: | 1235144957 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONNA DE PAOLO (OWNER) |
| Mailing Address: | 2007 75th St Woodridge |
| State: | IL US |
| Postal Code: | 605172308 |
| Phone Number: | 6309854700 |
| Fax Number: | 6309854523 |
| NPI Enumeration Date: | 07/30/2006 |
| NPI Last Update Date: | 12/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | 042007972 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |