Provider Demographics
NPI:1760625255
Name:TREATMENT CENTER FOR METABOLIC DISORDERS AND RESEARCH INSTITUTE SC
Entity Type:Organization
Organization Name:TREATMENT CENTER FOR METABOLIC DISORDERS AND RESEARCH INSTITUTE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:N
Authorized Official - Middle Name:S
Authorized Official - Last Name:BABU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-848-1707
Mailing Address - Street 1:1555 NAPERVILLE WHEATON RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1557
Mailing Address - Country:US
Mailing Address - Phone:630-848-1707
Mailing Address - Fax:
Practice Address - Street 1:1555 NAPERVILLE WHEATON RD
Practice Address - Street 2:SUITE 206
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1557
Practice Address - Country:US
Practice Address - Phone:630-848-1707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036422098207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty