Provider Demographics
NPI:1629301171
Name:DR JOSEPHINE POLICH DC PC
Entity Type:Organization
Organization Name:DR JOSEPHINE POLICH DC PC
Other - Org Name:DUPAGE HOMEOPATHIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:POLICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-717-0500
Mailing Address - Street 1:24W500 MAPLE AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6055
Mailing Address - Country:US
Mailing Address - Phone:630-717-0500
Mailing Address - Fax:630-717-0500
Practice Address - Street 1:24W500 MAPLE AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6055
Practice Address - Country:US
Practice Address - Phone:630-717-0500
Practice Address - Fax:630-717-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.009955261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center