Provider Demographics
NPI:1457309817
Name:DUPAGE VALLEY ANESTHESIOLOGISTS, LTD.
Entity Type:Organization
Organization Name:DUPAGE VALLEY ANESTHESIOLOGISTS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:M
Authorized Official - Last Name:GENTILE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-868-2200
Mailing Address - Street 1:387 SHUMAN BLVD
Mailing Address - Street 2:SUITE 240 W
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8450
Mailing Address - Country:US
Mailing Address - Phone:630-868-2200
Mailing Address - Fax:630-868-2240
Practice Address - Street 1:801 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7430
Practice Address - Country:US
Practice Address - Phone:630-355-0450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL337860Medicare ID - Type Unspecified