Provider Demographics
NPI:1700940707
Name:NAPERVILLE MEDICAL ASSOCIATES SC
Entity Type:Organization
Organization Name:NAPERVILLE MEDICAL ASSOCIATES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARDUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-527-6407
Mailing Address - Street 1:1891 BAY SCOTT CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1137
Mailing Address - Country:US
Mailing Address - Phone:630-527-6407
Mailing Address - Fax:630-527-6411
Practice Address - Street 1:1891 BAY SCOTT CIR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1137
Practice Address - Country:US
Practice Address - Phone:630-527-6407
Practice Address - Fax:630-527-6411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL940360Medicare ID - Type Unspecified