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NPI Code Detail

MEDICARE: LITTLE VILLAGE WOMENS HEALTH LLC

MEDICARE: LITTLE VILLAGE WOMENS HEALTH LLC
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
1207V00000XObstetrics & Gynecology Physician036093278IL

General Provider Information

NPI Number : 1518290089
Entity Type Code : Organization
Provider Name (Legal Business Name) : LITTLE VILLAGE WOMENS HEALTH LLC
Provider Business Mailing Address
First Line : 4230 W 26TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60623-4316
Country : US
Telephone Number : 773-277-2227
Fax Number : 773-522-5613
Provider Business Practice Location Address
First Line : 4230 W 26TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60623-4316
Country : US
Telephone Number : 773-277-2227
Fax Number : 773-522-5613
Authorized Official
Title or Position : PHYSICIAN
Name : DR. SONYA L THOMAS
Credential : MD
Telephone Number : 773-277-2227
Provider Enumeration Date : 09/15/2009
Last Update Date : 11/17/2010

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Directions to “LITTLE VILLAGE WOMENS HEALTH LLC ” Practice Location

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