Healthcare Provider Details

I. General information

NPI: 1154514438
Provider Name (Legal Business Name): WEST SUBURBAN OBSTETRICS & GYNECOLOGY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E 22ND STREET SUITE A
LOMBARD IL
60148-6102
US

IV. Provider business mailing address

500 E 22ND STREET SUITE A
LOMBARD IL
60148-6102
US

V. Phone/Fax

Practice location:
  • Phone: 630-620-8061
  • Fax: 630-916-7525
Mailing address:
  • Phone: 630-620-8061
  • Fax: 630-916-7525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036055553
License Number StateIL

VIII. Authorized Official

Name: DR. CHRISTOPHER A BARBOUR
Title or Position: PRESIDENT
Credential: MD
Phone: 630-620-8061