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Organization
ASTHMA AND ALLERGY WELLNESS CENTER LLC
Active
Organization
ASTHMA AND ALLERGY WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRIYA BANSAL MD (PRESIDENT)
(630) 247-4304
Entity
Organization
Contact information
Practice address
2900 FOXFIELD RD STE 203, ST CHARLES, IL 60174-5799
(630) 884-5704
Mailing address
1187 CLEANDER CT, NAPERVILLE, IL 60540-7352
(630) 247-4304
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
207KA0200X
Allergy Physician
—
—
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
—
—
Other
Enumeration date
12/05/2018
Last updated
01/09/2019
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