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Contact Information

DEKALB CLINIC CHARTERED
1850 GATEWAY DR
SYCAMORE, IL60178-3192
 Phone: 815-758-8671
 Fax: 815-758-5610
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Allergy & Immunology

207K00000X 03 Physician/Allergy/ Immunology
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Dermatology

207N00000X 07 Physician/Dermatology
 

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Mental Health

101YM0800X
 

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Surgery

208600000X 02 Physician/General Surgery
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
 

Urology

208800000X 34 Physician/Urology
 

Wound Care

163WW0000X
Indicates primary specialty

NPI Profile & details for DEKALB CLINIC CHARTERED · (Female)

NPI Number 1447277140
Status Active
Credentials
Entity Individual
Enumeration date 07/17/2006
Last updated 04/30/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 016-005282
  • IL License # 036119759
  • IL License # 036120383
  • IL Other 14D0415284 CLIA #
  • IL Other 148547 MC INDEPENDENT LAB
  • IL Other 663680 MEDICARE-GROUP ID
  • IL Other 1421279 NABP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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