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General NPI Number Information
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NPI Number | 1639401136
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Entity Type | Organization
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Legal Business Name | COMPLETE HEALTHCARE FOR WOMEN, S.C.
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 05/21/2010
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Provider Practice Location Address
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Address Line | 1435 N RANDALL RD 310
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City | ELGIN
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State | IL
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Zip | 60123-2306
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Country | US
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Telephone | 847-488-0800
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Fax | 847-841-8171
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Provider Business Mailing Address
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Address Line | 1435 N RANDALL RD SUITE # 310
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City | ELGIN
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State | IL
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Zip | 60123-2306
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Country | US
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Telephone | 847-488-0800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN F GLADDIN
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Credential | MD
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Telephone | 312-543-8724
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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 | 036089120
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License Number State | IL
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