Provider Demographics
NPI:1376896076
Name:AMEY J MUZUMDAR DC SC
Entity Type:Organization
Organization Name:AMEY J MUZUMDAR DC SC
Other - Org Name:GENUINE CARE HEALTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MUZUMDAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-567-1007
Mailing Address - Street 1:1303 MIDWEST CLUB PKWY
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2519
Mailing Address - Country:US
Mailing Address - Phone:630-567-1007
Mailing Address - Fax:630-325-8220
Practice Address - Street 1:850 N CASS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1394
Practice Address - Country:US
Practice Address - Phone:630-567-1007
Practice Address - Fax:630-325-8220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042620047261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center