Organization
LOCKPORT MEDICAL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VARUN BAJAJ (BILLER)
(718) 554-1024
Entity
Organization
Contact information
Practice address
27475 FERRY RD, WARRENVILLE, IL 60555-3808
(718) 554-1042
Mailing address
27475 FERRY RD, WARRENVILLE, IL 60555-3808
(718) 554-1024
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2017
Last updated
11/12/2018
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