NPIMap

Organization Active NPI

Dupage Health Specialist 2 LLC

  • Internal Medicine Physician
  • Lisle, IL
National Provider Identifier
1366716425
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DUPAGE HEALTH SPECIALIST 2 LLC
Practice address
3033 Ogden Ave
Suite 101
Lisle, IL 60532-1673
Phone
(630) 715-5700
Fax
(630) 717-0665
NPI assigned
Mar 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Alicia Holden
Title
Lab Billing Manager
Phone
(404) 943-0205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3033 Ogden Ave
Suite 101
Lisle, IL 60532-1673

Mailing address

5909 Peachtree Dunwoody Rd NE
Suite 900
Atlanta, GA 30328-8102
Phone (404) 943-0205

National Provider Directory

National Provider Directory

Locations

3033 Ogden Ave
Ste 101
Lisle, IL 60532
Phone (630) 646-6200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1366716425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5909 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303288102",
            "telephone_number": "404-943-0205",
            "fax_number": "404-943-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 OGDEN AVE",
            "address_2": "SUITE 101",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321673",
            "telephone_number": "630-715-5700",
            "fax_number": "630-717-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE HEALTH SPECIALIST 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-06",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "HOLDEN",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "LAB BILLING MANAGER",
        "authorized_official_telephone_number": "404-943-0205",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.