Provider Demographics
NPI:1538262951
Name:MIDWEST EAR, NOSE & THROAT CONSULTANTS, LTD.
Entity type:Organization
Organization Name:MIDWEST EAR, NOSE & THROAT CONSULTANTS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DONZELLI
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:630-668-2180
Mailing Address - Street 1:25 NORTH WINFIELD ROAD
Mailing Address - Street 2:SUITE 519
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1237
Mailing Address - Country:US
Mailing Address - Phone:630-668-2180
Mailing Address - Fax:630-668-2195
Practice Address - Street 1:25 NORTH WINFIELD ROAD
Practice Address - Street 2:SUITE 519
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1237
Practice Address - Country:US
Practice Address - Phone:630-668-2180
Practice Address - Fax:630-668-2195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02215113OtherBCBS
IL02215113OtherBCBS