Organization
ASTHMA AND ALLERGY WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRIYA BANSAL MD (PRESIDENT)
(630) 247-4304
Entity
Organization
Contact information
Practice address
2900 FOXFIELD RD STE 203, ST CHARLES, IL 60174-5799
(630) 884-5704
Mailing address
1187 CLEANDER CT, NAPERVILLE, IL 60540-7352
(630) 247-4304
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
207KA0200X
Allergy Physician
—
—
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
—
—
Other
Enumeration date
12/05/2018
Last updated
01/09/2019
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