Provider Demographics
NPI:1033443403
Name:EXPERIENCE HEALTH, S.C.
Entity Type:Organization
Organization Name:EXPERIENCE HEALTH, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-952-1412
Mailing Address - Street 1:3845 MCCOY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4429
Mailing Address - Country:US
Mailing Address - Phone:630-952-1412
Mailing Address - Fax:630-952-1447
Practice Address - Street 1:2850 W 95TH ST STE 301
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2741
Practice Address - Country:US
Practice Address - Phone:630-952-1412
Practice Address - Fax:630-952-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty