Basic Information
| Provider Information | |||||||||
| NPI: | 1568564615 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARDONE | ||||||||
| FirstName: | JOAN | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 545 PLAINFIELD RD STE C | ||||||||
| Address2: | |||||||||
| City: | WILLOWBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605277601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306542229 | ||||||||
| FaxNumber: | 6306553850 | ||||||||
| Practice Location | |||||||||
| Address1: | 545 PLAINFIELD RD | ||||||||
| Address2: | SUITE C | ||||||||
| City: | WILLOWBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605277600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306542229 | ||||||||
| FaxNumber: | 6306553270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 05/09/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 036-091264 | IL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 002223846 | 01 | BSBC | OTHER |