Provider Demographics
NPI:1083726442
Name:WEST SUBURBAN MIDWIFE ASSOCIATES, LTD
Entity Type:Organization
Organization Name:WEST SUBURBAN MIDWIFE ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEDMANN
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:078-848-3800
Mailing Address - Street 1:715 LAKE ST
Mailing Address - Street 2:SUITE 273
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1422
Mailing Address - Country:US
Mailing Address - Phone:708-848-3800
Mailing Address - Fax:
Practice Address - Street 1:715 LAKE ST
Practice Address - Street 2:SUITE 273
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1422
Practice Address - Country:US
Practice Address - Phone:708-848-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty