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Contact Information

SAMUEL M CORDOVA, PA-C
1259 RICKERT DR STE 101
NAPERVILLE, IL60540-8904
 Phone: 630-355-1300
 Fax: 630-355-3273
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SAMUEL M CORDOVA · (Male)

NPI Number 1326137225
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 10/11/2006
Last updated 12/13/2012 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085002213
  • IL License # 85002213
  • IL Medicaid 085002213
  • IL Other 970023229 RAILROAD MEDICARE
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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