Provider Demographics
NPI:1205082427
Name:PLAINFIELD HEALTHCARE ASSOCIATES, LLC
Entity type:Organization
Organization Name:PLAINFIELD HEALTHCARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-384-1256
Mailing Address - Street 1:2100 MANCHESTER ROAD
Mailing Address - Street 2:SUITE 615 BUILDING A
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187
Mailing Address - Country:US
Mailing Address - Phone:630-384-1256
Mailing Address - Fax:630-260-4120
Practice Address - Street 1:1012 95TH ST
Practice Address - Street 2:SUITE #8
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5041
Practice Address - Country:US
Practice Address - Phone:630-778-9444
Practice Address - Fax:630-778-9424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty