Provider Demographics
NPI:1386151520
Name:TODD HEWELL III MD LTD
Entity type:Organization
Organization Name:TODD HEWELL III MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEWELL FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-377-1133
Mailing Address - Street 1:260 W RIVER DR
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-5535
Mailing Address - Country:US
Mailing Address - Phone:630-377-1133
Mailing Address - Fax:630-584-4099
Practice Address - Street 1:260 W RIVER DR
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-5535
Practice Address - Country:US
Practice Address - Phone:630-377-1133
Practice Address - Fax:630-584-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical