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General NPI Number Information
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NPI Number | 1477974053
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Entity Type | Organization
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Legal Business Name | WOMEN'S HEALTH AND WELLNESS GROUP LTD
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Dates
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Enumeration Date | 12/26/2013
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Last Update Date | 12/26/2013
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Provider Practice Location Address
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Address Line | 9540 SOUTHWEST HWY
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City | OAK LAWN
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State | IL
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Zip | 60453-2802
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Country | US
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Telephone | 708-636-3333
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Fax | 708-346-3333
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Provider Business Mailing Address
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Address Line | 9540 SOUTHWEST HWY
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City | OAK LAWN
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State | IL
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Zip | 60453-2802
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Country | US
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Telephone | 708-636-3333
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Fax | 708-346-3333
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY JANE NOWAK
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Credential | M.D.
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Telephone | 708-636-3333
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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 | 036130807
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License Number State | IL
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