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General NPI Number Information
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NPI Number | 1689163008
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Entity Type | Organization
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Legal Business Name | AVANT OBSTETRICS AND GYNECOLOGY LTD.
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 05/02/2018
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Provider Practice Location Address
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Address Line | 201 E STRONG ST STE 3
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City | WHEELING
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State | IL
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Zip | 60090-2979
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Country | US
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Telephone | 847-461-3339
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E STRONG ST STE 3
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City | WHEELING
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State | IL
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Zip | 60090-2979
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Country | US
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Telephone | 847-461-3339
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. PAUL MICHAEL KUDER
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Credential | MD
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Telephone | 224-875-8337
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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 | 036-145710
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License Number State | IL
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