Provider Demographics
NPI:1447764014
Name:DR COURTNEY DRENDEL INC
Entity Type:Organization
Organization Name:DR COURTNEY DRENDEL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-921-3847
Mailing Address - Street 1:515 HAMILTON ST # 100
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2138
Mailing Address - Country:US
Mailing Address - Phone:630-232-7611
Mailing Address - Fax:630-232-7612
Practice Address - Street 1:515 HAMILTON ST # 100
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2138
Practice Address - Country:US
Practice Address - Phone:630-232-7611
Practice Address - Fax:630-232-7612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-19
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
123456OtherCAQH