MEDICARE: GYNECOLOGY INSTITUTE OF CHICAGO LTD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	036116334	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1164441051	OTHER		PERSONAL NPI

General Provider Information

NPI Number	:	1235573197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GYNECOLOGY INSTITUTE OF CHICAGO LTD.

Provider Business Mailing Address
First Line	:	680 N LAKE SHORE DR STE 1424
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-8700
Country	:	US
Telephone Number	:	312-929-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DR STE 1424
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-8700
Country	:	US
Telephone Number	:	312-929-9191
Fax Number	:	312-566-8986

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NICOLE WILLIAMS
Credential	:	M.D.
Telephone Number	:	312-929-9191

Provider Enumeration Date	:	04/23/2013
Last Update Date	:	08/06/2025

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