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General NPI Number Information
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NPI Number | 1306913454
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Entity Type | Organization
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Legal Business Name | CHICAGO METROPOLITAN OBSTETRICIANS & GYNECOLOGISTS, LTD
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 15620 S. WOOD STREET
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City | HARVEY
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State | IL
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Zip | 60426-4171
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Country | US
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Telephone | 708-333-3030
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Fax | 708-333-7453
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Provider Business Mailing Address
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Address Line | PO BOX 4685
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City | CHICAGO
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State | IL
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Zip | 60680-4685
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Country | US
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Telephone | 708-333-3030
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Fax | 708-333-7453
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. ERNEST A. HAYES
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Credential | M.D.
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Telephone | 708-333-3030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036043976
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License Number State | IL
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