Organization
MIDWEST NEUROLOGY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW D TA D.O. (PRESIDENT)
(630) 906-9470
Entity
Organization
Contact information
Practice address
181 S LINCOLNWAY, NORTH AURORA, IL 60542-1609
(630) 906-9470
(630) 906-9467
Mailing address
181 S LINCOLNWAY, NORTH AURORA, IL 60542-1609
(630) 906-9470
(630) 906-9467
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036-074755
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4522088
BLUECROSS BLUESHIELD
IL
Enumeration date
01/15/2007
Last updated
03/06/2008
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