Organization
EDWARD HEALTH VENTURES
Active
Other names
Edward Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM G. KOTTMAN (PRESIDENT)
(630) 646-3950
Entity
Organization
Contact information
Practice address
130 N WEBER RD, SUITE 100, BOLINGBROOK, IL 60440-1564
(630) 646-5777
(630) 646-5729
Mailing address
27555 DIEHL RD, WARRENVILLE, IL 60555
(630) 646-3950
(630) 646-3797
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9919630
BCBS
IL
Enumeration date
05/11/2006
Last updated
03/27/2009
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