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General NPI Number Information
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NPI Number | 1417210030
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Entity Type | Organization
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Legal Business Name | ALPHA FERTILITY INC.
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 06/19/2012
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Provider Practice Location Address
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Address Line | 8635 LEMONT RD
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-4805
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Country | US
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Telephone | 630-427-0309
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Fax | 630-427-0302
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Provider Business Mailing Address
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Address Line | 8635 LEMONT RD
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-4805
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Country | US
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Telephone | 630-427-0309
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Fax | 630-427-0302
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | HISHAM GREISS
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Credential | M.D., PHD, HCLD, TBS
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Telephone | 630-427-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number | D141357
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License Number State | FL
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