Dr. Mary Deherrera-Codo MD PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

03-6082140 Issued in IL

Legal business name

DR. MARY DEHERRERA-CODO MD PC

Practice address

720 Brom CT
Suit 204
Naperville, IL 60540-6531

Phone

(630) 848-1332

Fax

(630) 838-1344

NPI assigned

Feb 22, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mary Deherrera-Codo, MD

Title

Owner

Phone

(630) 848-1332

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1780957654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 BROM CT",
            "address_2": "SUIT 204",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406531",
            "telephone_number": "630-848-1332",
            "fax_number": "630-838-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 BROM CT",
            "address_2": "SUIT 204",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406531",
            "telephone_number": "630-848-1332",
            "fax_number": "630-838-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARY DEHERRERA-CODO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "DEHERRERA-CODO",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-848-1332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "03-6082140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Endocrinology, Diabetes & Metabolism Physician in Illinois

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