Provider Demographics
NPI:1780637744
Name:DUPAGE NEPHROLOGY ASSOCIATES SC
Entity Type:Organization
Organization Name:DUPAGE NEPHROLOGY ASSOCIATES SC
Other - Org Name:DUPAGE NEPHRO MED ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUKHSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-832-2183
Mailing Address - Street 1:183 N ADDISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126
Mailing Address - Country:US
Mailing Address - Phone:630-832-2183
Mailing Address - Fax:630-832-2184
Practice Address - Street 1:183 N ADDISON AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:630-832-2183
Practice Address - Fax:630-832-2184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2215498OtherBCBS OF IL PROVIDER ID
IL=========OtherTIN
IL=========OtherTIN