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General NPI Number Information
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NPI Number | 1881789279
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Entity Type | Organization
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Legal Business Name | VALLEY WOMEN'S HEALTH S.C
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 2121 RIDGE AVE,SUITE 103
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City | AURORA
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State | IL
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Zip | 60504
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Country | US
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Telephone | 630-375-0101
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Fax | 630-375-1311
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Provider Business Mailing Address
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Address Line | 2541 FAWNLAKE CIRCLE
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City | NAPERVILLE
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State | IL
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Zip | 60564
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Country | US
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Telephone | 630-375-0101
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Fax | 630-375-1311
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Authorized Official
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Title or Position | FINANCES
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Name | DR. SHRISH S TOMUR
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Credential | M.D
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Telephone | 630-375-0101
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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 | 036090195
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License Number State | IL
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