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General NPI Number Information
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NPI Number | 1851563134
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Entity Type | Organization
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Legal Business Name | WOMENS DOC OF BLOOMINGDALE S.C.
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 290 SPRINGFIELD DR SUITE 290
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2214
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Country | US
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Telephone | 630-582-8600
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Fax | 630-582-1369
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Provider Business Mailing Address
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Address Line | PO BOX 957706
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60195-7706
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Country | US
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Telephone | 847-839-8800
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Fax | 847-839-8808
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHERI B MERCHANT
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Credential | MD
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Telephone | 847-839-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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