Organization
DUPAGE ENT, LLC
Active
Other names
DuPage Children's ENT & Allergy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANALI S AMIN MD (PHYSICIAN)
(617) 785-0367
Entity
Organization
Contact information
Practice address
1331 W 75TH ST, NAPERVILLE, IL 60540-9310
(630) 761-5531
Mailing address
1331 W 75TH ST, NAPERVILLE, IL 60540-9310
(630) 761-5531
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
8874117
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982675310
CMS
MA
Enumeration date
11/04/2014
Last updated
02/18/2020
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