Lockport Medical Wellness LLC

NPI #1093233199 in Warrenville, Illinois

Provider Information

NPI Number: 1093233199
Entity Type: Organization
Organization Name: Lockport Medical Wellness LLC
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Sep 8, 2017
Last Updated: Nov 12, 2018

Practice Location

Address: 27475 FERRY RD
City: Warrenville
State: Illinois
ZIP Code: 60555-3808
Phone: (718) 554-1042

Authorized Official

Name: VARUN BAJAJ
Title: BILLER
Phone: (718) 554-1024

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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