Prairie Trail Family Medicine SC
Prairie Trail Family Medicine SC is a Family Medicine Physician in Warrenville, Illinois. Licensed in Illinois. Registered with an NPI since 2007.
- Licensed in
- IL
- In the registry since
- 2007
Practice location Address checks out
2S661 Angeline CtWarrenville, IL 60555-1301
Phone: (630) 341-1246
Fax: (630) 489-9652
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence 042006514 (IL) |
|---|
Record details
| NPI number | 1003031352 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Pauline Harding — President · (630) 341-1246 |
| NPI enumerated | April 13, 2007 |
| Last updated in NPPES | February 21, 2022 |
| Certification date | February 21, 2022 |
| Mailing address | 2s661 Angeline Ct, Warrenville, IL 60555-1301 |
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