Provider Demographics
NPI:1043348477
Name:OAK BROOK FERTILITY CENTER, LTD.
Entity Type:Organization
Organization Name:OAK BROOK FERTILITY CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:W.
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:DMOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PH-D
Authorized Official - Phone:630-954-0054
Mailing Address - Street 1:11999 SAN VICENTE BLVD
Mailing Address - Street 2:STE. 440
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5131
Mailing Address - Country:US
Mailing Address - Phone:310-471-5852
Mailing Address - Fax:310-471-3958
Practice Address - Street 1:2425 W 22ND ST
Practice Address - Street 2:STE. 102
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1245
Practice Address - Country:US
Practice Address - Phone:630-954-0054
Practice Address - Fax:630-954-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility