Provider Demographics
NPI:1033525191
Name:PLANNED PARENTHOOD OF ILLINOIS
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-592-6892
Mailing Address - Street 1:17 N STATE ST STE 500
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3384
Mailing Address - Country:US
Mailing Address - Phone:312-592-6800
Mailing Address - Fax:312-592-6801
Practice Address - Street 1:16 N WABASH STREET
Practice Address - Street 2:SUITE 500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3200
Practice Address - Country:US
Practice Address - Phone:312-592-6700
Practice Address - Fax:312-592-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009336367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty