MEDICARE: A WOMANS PLACE INC

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	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000222495	OTHER	IN	BLUE CROSS BLUE SHHEILD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396949525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A WOMANS PLACE INC

Provider Business Mailing Address
First Line	:	619 S WASHINGTON ST
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-6772
Country	:	US
Telephone Number	:	630-548-9346
Fax Number	:	630-548-9376

Provider Business Practice Location Address
First Line	:	619 S WASHINGTON ST
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-6772
Country	:	US
Telephone Number	:	630-548-9346
Fax Number	:	630-548-9376

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	MRS. BELINDA J DUST
Credential	:
Telephone Number	:	630-548-9346

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	06/22/2010

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Directions to “A WOMANS PLACE INC ” Practice Location

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