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General NPI Number Information
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NPI Number | 1508183583
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Entity Type | Organization
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Legal Business Name | THE WOMEN INSTITUTE SC
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 4101 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60618-2813
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Country | US
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Telephone | 773-382-1224
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Fax | 773-362-1085
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Provider Business Mailing Address
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Address Line | 1629 S PRAIRIE AVE # 1508
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City | CHICAGO
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State | IL
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Zip | 60616-4403
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Country | US
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Telephone | 773-382-1224
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Fax | 773-362-1085
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CLAUDIA RODRIGUEZ
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Credential | MD
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Telephone | 773-382-1224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 036118733
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License Number State | IL
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