Healthcare Provider Details

I. General information

NPI: 1851324636
Provider Name (Legal Business Name): REPRODUCTIVE GENETICS INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 10/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 MACARTHUR BLVD
NORTHBROOK IL
60062-2005
US

IV. Provider business mailing address

2910 MACARTHUR BLVD
NORTHBROOK IL
60062-2005
US

V. Phone/Fax

Practice location:
  • Phone: 847-400-1515
  • Fax: 847-400-1516
Mailing address:
  • Phone: 847-400-1515
  • Fax: 847-400-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207SM0001X
TaxonomyMolecular Genetic Pathology (Medical Genetics) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: OLEG L. VERLINSKY
Title or Position: CEO
Credential:
Phone: 847-400-1515