Organization
SURGICAL CONSULTANTS OF DUPAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL J DOUGLAS M.D. (MANAGING PARTNER)
(630) 325-3310
Entity
Organization
Contact information
Practice address
908 N ELM ST, SUITE 310, HINSDALE, IL 60521-3635
(630) 325-3310
(630) 325-9163
Mailing address
908 N ELM ST, SUITE 310, HINSDALE, IL 60521-3635
(630) 325-3310
(630) 325-9163
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036095786
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002220321
BCBS GROUP PROVIDER NUM
IL
01
—
CD5773
RR MEDICARE
IL
Enumeration date
01/26/2007
Last updated
04/25/2008
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