Healthcare Provider Details

I. General information

NPI: 1417980277
Provider Name (Legal Business Name): LINDSEY WAITZMAN MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTER FOR WOMEN'S HEALTH (MC/650) 1801 W. TAYLOR, SUITE 4C
CHICAGO IL
60612
US

IV. Provider business mailing address

520 N HALSTED ST #305
CHICAGO IL
60622-7369
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-5807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: