Healthcare Provider Details

I. General information

NPI: 1023186079
Provider Name (Legal Business Name): WOMEN'S HEALTHCARE SPECIALISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 MEMORIAL DR STE 400 MEDICAL OFFICE CENTER TWO
BELLEVILLE IL
62226-5366
US

IV. Provider business mailing address

4600 MEMORIAL DR STE 400 MEDICAL OFFICE CENTER TWO
BELLEVILLE IL
62226-5366
US

V. Phone/Fax

Practice location:
  • Phone: 618-234-2390
  • Fax: 618-234-9936
Mailing address:
  • Phone: 618-234-2390
  • Fax: 618-234-9936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. WILLIAM A CHADWICK
Title or Position: PRESIDENT
Credential: M.D.
Phone: 618-234-2390