Organization
CENTRAL DUPAGE HEALTH
Active
Other names
Midwest Pathology Services
Organization subpart
No
Provider details
NPI number
Authorized official
GENE HEIDT (DIRECTORY LABORATORY SERVICES)
(630) 933-4027
Entity
Organization
Contact information
Practice address
DEPT 4003, CAROL STREAM, IL 60122-4698
(630) 462-7997
(630) 933-2555
Mailing address
DEPT 4003, CAROL STREAM, IL 60122-4698
(630) 462-7997
(630) 933-2555
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2215171
BLUE CROSS GROUP NUMBER
IL
01
—
CF3455
MEDICARE RR RETIREMENT
—
Enumeration date
03/13/2007
Last updated
01/29/2009
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