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General NPI Number Information
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NPI Number | 1013135771
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Entity Type | Organization
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Legal Business Name | WOMENS HEALTHCARE ASSOCIATES OF IL, SC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 17901 GOVERNORS HWY SUITE 103
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City | HOMEWOOD
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State | IL
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Zip | 60430-1144
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Country | US
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Telephone | 708-799-6450
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Fax | 708-799-6560
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Provider Business Mailing Address
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Address Line | PO BOX 2190
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City | ORLAND PARK
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State | IL
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Zip | 60462-1085
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Country | US
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Telephone | 708-799-6450
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Fax | 708-799-6560
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Authorized Official
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Title or Position | PRESIDENT
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Name | BIREN P SHAH
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Credential | M.D.
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Telephone | 708-799-6450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 036108162
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License Number State | IL
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