MEDICARE: NOVA MED WOMENS CARE PLLC

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1801516182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVA MED WOMENS CARE PLLC

Provider Business Mailing Address
First Line	:	1717 W ALGONQUIN RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-5401
Country	:	US
Telephone Number	:	847-939-3139
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 W ALGONQUIN RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-5401
Country	:	US
Telephone Number	:	847-939-3139
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUTHORIZED OFFICIAL
Name	:	BAKYTBUBU ARYNOVA
Credential	:	MD
Telephone Number	:	847-939-3139

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	08/29/2022

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