Healthcare Provider Details

I. General information

NPI: 1437472537
Provider Name (Legal Business Name): REPRODUCTIVE MEDICINE INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 W 22ND ST STE 102
OAK BROOK IL
60523-4643
US

IV. Provider business mailing address

2425 W 22ND ST STE 102
OAK BROOK IL
60523-4643
US

V. Phone/Fax

Practice location:
  • Phone: 630-954-0054
  • Fax: 630-954-0064
Mailing address:
  • Phone: 630-954-0054
  • Fax: 630-954-0064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHERIE EVERHART
Title or Position: OFFICE MANAGER
Credential:
Phone: 630-954-0054