Provider Demographics
NPI:1851908842
Name:CENTRAL DUPAGE HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:CENTRAL DUPAGE HOSPITAL ASSOCIATION
Other - Org Name:HEALTHLAB, PART OF NORTHWESTERN MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, OPERATION- LABORATORY ADMINISTR
Authorized Official - Prefix:MR
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-933-2093
Mailing Address - Street 1:25 N. WINFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190
Mailing Address - Country:US
Mailing Address - Phone:630-933-2633
Mailing Address - Fax:630-933-2628
Practice Address - Street 1:25 N. WINFIELD ROAD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190
Practice Address - Country:US
Practice Address - Phone:630-933-2633
Practice Address - Fax:630-933-2628
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL DUPAGE HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-24
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory