Cmby Clinic, LTD.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

42003094 Issued in IL

Legal business name

CMBY CLINIC, LTD.

Practice address

135 S Cottage Hill Ave
Elmhurst, IL 60126-3330

Phone

(630) 832-6633

Fax

(630) 832-6653

NPI assigned

Oct 10, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Charlotte Marie Blain, M.D.

Title

President

Phone

(630) 832-6633

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508854969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S COTTAGE HILL AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263330",
            "telephone_number": "630-832-6633",
            "fax_number": "630-832-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S COTTAGE HILL AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263330",
            "telephone_number": "630-832-6633",
            "fax_number": "630-832-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMBY CLINIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLAIN",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-832-6633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IL",
            "license": "42003094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Health Service Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.