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General NPI Number Information
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NPI Number | 1619225174
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Entity Type | Organization
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Legal Business Name | CHICAGO OB-GYN ULTRASOUND SC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 2825 N HALSTED ST 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60657-5105
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Country | US
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Telephone | 773-322-7382
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Fax | 773-935-3691
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Provider Business Mailing Address
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Address Line | 2825 N HALSTED ST 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60657-5105
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Country | US
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Telephone | 773-322-7382
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Fax | 773-935-3691
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | JACQUES S ABRAMOWICZ
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Credential | M.D.
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Telephone | 773-322-7382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 036101996
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License Number State | IL
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