Healthcare Provider Details

I. General information

NPI: 1831662931
Provider Name (Legal Business Name): OVA INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N MICHIGAN AVE STE 1800
CHICAGO IL
60611-4225
US

IV. Provider business mailing address

401 N MICHIGAN AVE STE 1800
CHICAGO IL
60611-4225
US

V. Phone/Fax

Practice location:
  • Phone: 312-800-0228
  • Fax:
Mailing address:
  • Phone: 312-800-0228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN WAGNER COUGHLIN
Title or Position: CEO
Credential:
Phone: 312-800-0228