MEDICARE: PLANNED PARENTHOOD OF ILLINOIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205242120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD OF ILLINOIS

Provider Business Mailing Address
First Line	:	17 N STATE ST STE 500
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3384
Country	:	US
Telephone Number	:	312-592-6800
Fax Number	:	312-592-6801

Provider Business Practice Location Address
First Line	:	1152 N. MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-4010
Country	:	US
Telephone Number	:	773-252-2240
Fax Number	:	773-252-2267

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	ERIKA R GONZALEZ
Credential	:
Telephone Number	:	312-592-6892

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	10/13/2022

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Directions to “PLANNED PARENTHOOD OF ILLINOIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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