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General NPI Number Information
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NPI Number | 1649255902
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Entity Type | Organization
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Legal Business Name | LAKE FOREST OBSTETRICS GYNECOLOGY & INFERTILITY S.C.
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 900 N WESTMORELAND RD SUITE 228
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City | LAKE FOREST
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State | IL
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Zip | 60045-1674
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Country | US
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Telephone | 847-234-3860
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Fax | 847-234-3981
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Provider Business Mailing Address
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Address Line | 900 N WESTMORELAND RD SUITE 228
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City | LAKE FOREST
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State | IL
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Zip | 60045-1674
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Country | US
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Telephone | 847-234-3860
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Fax | 847-234-3981
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. SHEILA SCHEWITZ
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Credential |
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Telephone | 847-234-3860
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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 |
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License Number State |
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