Provider Demographics
NPI:1386175313
Name:KING, PAIGE E (MD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:E
Last Name:KING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 OGDEN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7205
Mailing Address - Country:US
Mailing Address - Phone:630-978-6886
Mailing Address - Fax:630-978-6806
Practice Address - Street 1:2040 OGDEN AVE STE 201
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7205
Practice Address - Country:US
Practice Address - Phone:630-978-6886
Practice Address - Fax:630-978-6806
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036156916207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology