MEDICARE: CHICAGO GYNECOLOGIC ONCOLOGY, S.C.

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	174400000X	Specialist	036-047122	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548256506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO GYNECOLOGIC ONCOLOGY, S.C.

Provider Business Mailing Address
First Line	:	120 W GOLF RD
Second Line	:	SUITE 212
City	:	SCHAUMBURG
State	:	IL
Zip	:	60195-5179
Country	:	US
Telephone Number	:	847-490-0144
Fax Number	:	847-430-1236

Provider Business Practice Location Address
First Line	:	120 W GOLF RD
Second Line	:	SUITE 212
City	:	SCHAUMBURG
State	:	IL
Zip	:	60195-5179
Country	:	US
Telephone Number	:	847-490-0144
Fax Number	:	847-490-1236

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MRS. BANU YAGCI
Credential	:
Telephone Number	:	847-490-0144

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	06/22/2015

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