# WESTERN DUPAGE OB/GYN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WESTERN DUPAGE OB/GYN
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1831475466
- **Legal business name:** WESTERN DUPAGE OB/GYN
- **Authorized official:** DANIELLE MARIE EVERETT PA-C (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (630) 810-0777

## Contact information

- **Practice address:** 3800 HIGHLAND AVE, DOWNERS GROVE, IL 60515-1557
- **Practice address phone:** (630) 810-0777
- **Mailing address:** 609 REBECCA LN, BOLINGBROOK, IL 60440-4859
- **Mailing address phone:** (630) 392-5025

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AM0700X | Medical Physician Assistant | 085004210 | IL | Yes |

## Other

- **Enumeration date:** 10/27/2011
- **Last updated:** 10/27/2011