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

General Provider Information

NPI Number	:	1831506773
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	:	3051 E NEW YORK ST
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-5160
Country	:	US
Telephone Number	:	630-585-0500
Fax Number	:	630-585-5588

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	:	10/17/2022

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Directions to “PLANNED PARENTHOOD OF ILLINOIS ” Practice Location

Language	Start Address	Practice Location

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