Provider Demographics
NPI:1720039191
Name:MAUREEN ANN VILLAGELIU NAPERVILLE SOUTH PEDIATRICS
Entity Type:Organization
Organization Name:MAUREEN ANN VILLAGELIU NAPERVILLE SOUTH PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:VILLAGELIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-548-5437
Mailing Address - Street 1:1819 BAY SCOTT CIRCLE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1102
Mailing Address - Country:US
Mailing Address - Phone:630-548-5437
Mailing Address - Fax:630-548-1646
Practice Address - Street 1:1819 BAY SCOTT CIRCLE
Practice Address - Street 2:SUITE 105
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1102
Practice Address - Country:US
Practice Address - Phone:630-548-5437
Practice Address - Fax:630-584-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-077359208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty