Organization
NEUROMED CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY L BANKS (DIRECTOR PHYSICIAN & PATIENT SVCS)
(630) 836-9121
Entity
Organization
Contact information
Practice address
25 N WINFIELD RD, STE 500, WINFIELD, IL 60190-1222
(630) 836-9121
(630) 836-9126
Mailing address
3S517 WINFIELD RD, STE A, WARRENVILLE, IL 60555-3159
(630) 836-9121
(630) 836-9126
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
—
IL
2084N0400X
Neurology Physician
Primary
—
IL
2084P0800X
Psychiatry Physician
—
IL
363L00000X
Nurse Practitioner
—
IL
Other
Enumeration date
07/20/2007
Last updated
10/27/2007
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