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General NPI Number Information
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NPI Number | 1477611028
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Entity Type | Organization
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Legal Business Name | WOMENS SPECIALTY CARE SC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 840 S WAUKEGAN RD STE 208
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City | LAKE FOREST
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State | IL
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Zip | 60045-2619
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Country | US
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Telephone | 847-295-0433
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Fax | 847-234-0034
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Provider Business Mailing Address
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Address Line | 475 MCCORMICK DR
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City | LAKE FOREST
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State | IL
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Zip | 60045-3349
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Country | US
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Telephone | 847-295-0433
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Fax | 847-295-0439
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KAREN J MASS
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Credential | MD
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Telephone | 847-295-0433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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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 | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036093085
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License Number State | IL
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