NPI 1003031352

Prairie Trail Family Medicine Sc

Organisation Family Medicine Physician Warrenville, IL

Practice location

Address: 2s661 Angeline CT, Warrenville, IL 60555-1301
Phone: (630) 341-1246
Fax: (630) 489-9652

Authorised official

Name: Pauline N Harding
Title: President
Phone: (630) 341-1246

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 042006514 (IL)

Other Family Medicine providers in Illinois →

Registry record

NPI: 1003031352
Entity type: Organization
NPI issued: 13 Apr 2007
Record last updated: 21 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.