Organization
WOODRIDGECLINIC S.C
Active
Parent organization
WOODRIDGECLINIC S.C
Other names
LILAC PARK MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
WOODRIDGECLINIC S.C
Authorized official
PARAGI U PATEL (BUSINESS MANAGER)
(630) 324-4677
Entity
Organization
Contact information
Practice address
805 S MAIN ST, LOMBARD, IL 60148-3300
(630) 620-6225
Mailing address
7530 WOODWARD AVE, SUITE A, WOODRIDGE, IL 60517-3100
(630) 910-1177
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
042-0060088
IL
2080A0000X
Pediatric Adolescent Medicine Physician
042-0060088
IL
208D00000X
General Practice Physician
Primary
042-006088
IL
Other
Enumeration date
08/04/2008
Last updated
10/20/2023
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