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Organization
OPEN DOOR CLINIC
Active
Organization
OPEN DOOR CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ROESLER (EXECUTIVE DIRECTOR)
(630) 707-7704
Entity
Organization
Contact information
Practice address
157 S LINCOLN AVE, SUITE K, AURORA, IL 60505-4264
(630) 264-1819
(630) 229-0182
Mailing address
157 S LINCOLN AVE, SUITE K, AURORA, IL 60505-4264
(630) 264-1819
(630) 229-0182
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
207RI0200X
Infectious Disease Physician
Primary
—
NULL
207RI0200X
Infectious Disease Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
363LA2100X
Acute Care Nurse Practitioner
—
NULL
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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