Organization
PENNSYLVANIA PHLEBOLOGY GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA JONES (CREDENTIALING)
(630) 725-2737
Entity
Organization
Contact information
Practice address
707 EAGLEVIEW BLVD STE 303, EXTON, PA 19341-1159
(610) 321-2615
(610) 321-2616
Mailing address
2015 SPRING RD STE 300, OAK BROOK, IL 60523-3944
(630) 725-2700
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
—
PA
2085R0204X
Vascular & Interventional Radiology Physician
—
PA
208600000X
Surgery Physician
Primary
—
PA
2086S0129X
Vascular Surgery Physician
—
PA
Other
Enumeration date
07/17/2008
Last updated
02/08/2022
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