Provider Demographics
NPI:1982978300
Name:NEUROLOGICAL HEALTHCARE OF DUPAGE, LLC
Entity Type:Organization
Organization Name:NEUROLOGICAL HEALTHCARE OF DUPAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ECHIVERRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-836-9121
Mailing Address - Street 1:3S 517 WINFIELD ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3160
Mailing Address - Country:US
Mailing Address - Phone:630-836-9121
Mailing Address - Fax:630-836-9126
Practice Address - Street 1:3S517 WINFIELD RD
Practice Address - Street 2:SUITE A
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3159
Practice Address - Country:US
Practice Address - Phone:630-836-9121
Practice Address - Fax:630-836-9126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty