Healthcare Provider Details

I. General information

NPI: 1346363983
Provider Name (Legal Business Name): WOMENS HEALTH ASSOCIATES OF CENTRAL IL, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 EASTLAND DR SUITE 250
BLOOMINGTON IL
61701-3534
US

IV. Provider business mailing address

1505 EASTLAND DR SUITE 250
BLOOMINGTON IL
61701-3534
US

V. Phone/Fax

Practice location:
  • Phone: 309-662-8541
  • Fax:
Mailing address:
  • Phone: 309-662-8541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: PAT CARR
Title or Position: OFFICE MANAGER
Credential:
Phone: 309-662-8541