Healthcare Provider Details

I. General information

NPI: 1295763886
Provider Name (Legal Business Name): WOMEN'S DOC OF ELGIN, S. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 N AIRLITE ST SUITE G14
ELGIN IL
60123-4988
US

IV. Provider business mailing address

PO BOX 95748
HOFFMAN ESTATES IL
60195-0748
US

V. Phone/Fax

Practice location:
  • Phone: 847-289-6020
  • Fax: 847-289-6029
Mailing address:
  • Phone: 847-839-8800
  • Fax: 847-839-8808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036116215
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERI B MERCHANT
Title or Position: PRESIDENT
Credential: MD
Phone: 847-839-8800