Organization
DUPAGE HEALTH AND PHYSICAL THERAPY CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD R. FAY DC (OWNER)
(331) 401-5900
Entity
Organization
Contact information
Practice address
1795 S WASHINGTON ST STE 109, NAPERVILLE, IL 60565-2058
(331) 401-5900
(331) 215-7318
Mailing address
1795 S WASHINGTON ST STE 109, NAPERVILLE, IL 60565-2058
(630) 961-0259
(630) 961-2406
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
042-618902
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232874
BLUE CROSSBLUE SHIELD
IL
Enumeration date
12/20/2006
Last updated
10/14/2024
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