Provider Demographics
NPI:1235315458
Name:JAMES G CUNNAR MD SC
Entity Type:Organization
Organization Name:JAMES G CUNNAR MD SC
Other - Org Name:DUPAGE FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:CUNNAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-778-4700
Mailing Address - Street 1:2272 W 95TH ST
Mailing Address - Street 2:SUITE 325
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8942
Mailing Address - Country:US
Mailing Address - Phone:630-778-4700
Mailing Address - Fax:
Practice Address - Street 1:2272 W 95TH ST
Practice Address - Street 2:SUITE 325
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8942
Practice Address - Country:US
Practice Address - Phone:630-778-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-095349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL566180Medicare PIN