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Organization
CENTRAL DUPAGE HEALTH
Active
Organization
CENTRAL DUPAGE HEALTH
Active
Other names
Midwest Pathology Services
Organization subpart
No
Provider details
NPI number
Authorized official
GENE HEIDT (DIRECTORY LABORATORY SERVICES)
(630) 933-4027
Entity
Organization
Contact information
Practice address
DEPT 4003, CAROL STREAM, IL 60122-4698
(630) 462-7997
(630) 933-2555
Mailing address
DEPT 4003, CAROL STREAM, IL 60122-4698
(630) 462-7997
(630) 933-2555
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2215171
BLUE CROSS GROUP NUMBER
IL
01
—
CF3455
MEDICARE RR RETIREMENT
—
Enumeration date
03/13/2007
Last updated
01/29/2009
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