Organization
WESTERN DUPAGE OB/GYN
Active
Parent organization
WESTERN DUPAGE OB/GYN
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN DUPAGE OB/GYN
Authorized official
DANIELLE MARIE EVERETT PA-C (PHYSICIAN ASSISTANT)
(630) 810-0777
Entity
Organization
Contact information
Practice address
3800 HIGHLAND AVE, DOWNERS GROVE, IL 60515-1557
(630) 810-0777
Mailing address
609 REBECCA LN, BOLINGBROOK, IL 60440-4859
(630) 392-5025
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085004210
IL
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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