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EDWARD HEALTH VENTURES NPI 1174573109


NPI Information

NPI: 1174573109
Provider Name: EDWARD HEALTH VENTURES

Other Name: EDWARD MEDICAL GROUP

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1025 OGDEN AVE
LISLE, IL
ZIP 60532
Phone: (630) 515-1667
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EDWARD HEALTH VENTURES is a multi-specialty clinic center in Lisle, IL. EDWARD HEALTH VENTURES NPI is 1174573109. The provider is registered as an organization entity type.
The provider Other Name Is Edward Medical Group.

The provider's business location address is:

1025 OGDEN AVE
LISLE, IL
ZIP 60532-388
Phone: (630) 515-1667
Fax: (630) 515-1825

The provider's authorized official is William G. Kottman .
The authorized official title is President and has the following contact phone number (630) 646-3950.

The enumeration date for this NPI number is 5/11/2006 and was last updated on 3/27/2009.


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
1261QM1300XClinic/CenterMulti-SpecialtyYes

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
1432690MEDICARE PINILLINOIS
22222543OTHERILLINOISBCBS
3CC2969MEDICARE PINILLINOIS

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
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