Provider Demographics
NPI:1033122726
Name:ASSOCIATES IN OBSTETRICS & GYNECOLOGY SC
Entity Type:Organization
Organization Name:ASSOCIATES IN OBSTETRICS & GYNECOLOGY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:309-663-0411
Mailing Address - Street 1:2304 STERN DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-4406
Mailing Address - Country:US
Mailing Address - Phone:309-663-0411
Mailing Address - Fax:309-662-2018
Practice Address - Street 1:2304 STERN DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-4406
Practice Address - Country:US
Practice Address - Phone:309-663-0411
Practice Address - Fax:309-662-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5700239OtherBLUE CROSS BLUE SHIELD
IL205915Medicare ID - Type UnspecifiedMEDICARE GROUP