Provider Demographics
NPI:1881716066
Name:W.P. DMOWSKI, M.D.. PH.D. & ASSOCIATES S.C.
Entity type:Organization
Organization Name:W.P. DMOWSKI, M.D.. PH.D. & ASSOCIATES S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:W
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:DMOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:630-954-0054
Mailing Address - Street 1:2425 W 22ND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1245
Mailing Address - Country:US
Mailing Address - Phone:630-954-0054
Mailing Address - Fax:630-954-0064
Practice Address - Street 1:2425 W 22ND ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1245
Practice Address - Country:US
Practice Address - Phone:630-954-0054
Practice Address - Fax:630-954-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL022-15570OtherBC/BS