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General NPI Number Information
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NPI Number | 1164566345
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE WOMENS CENTER
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 1083 E LAKE COOK RD
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City | WHEELING
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State | IL
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Zip | 60090-2502
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Country | US
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Telephone | 847-808-7070
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Fax | 847-808-7474
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Provider Business Mailing Address
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Address Line | 1083 E LAKE COOK RD
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City | WHEELING
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State | IL
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Zip | 60090-2502
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Country | US
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Telephone | 847-808-7070
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Fax | 847-808-7474
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MARY C CHLIPALA
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Credential |
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Telephone | 847-808-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 042617403
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License Number State | IL
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