MEDICARE: GIVING REAL OPPORTUNITIES TO WOMEN

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1437344454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIVING REAL OPPORTUNITIES TO WOMEN

Provider Business Mailing Address
First Line	:	270 COUNTRY COMMONS RD
Second Line	:
City	:	TROUT VALLEY
State	:	IL
Zip	:	60013-2503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	270 COUNTRY COMMONS RD
Second Line	:
City	:	TROUT VALLEY
State	:	IL
Zip	:	60013-2503
Country	:	US
Telephone Number	:	847-502-7926
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. ERIKA HUBER
Credential	:
Telephone Number	:	847-502-7926

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	09/12/2007

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