Provider Demographics
NPI:1114392354
Name:ALL ABOUT WOMENS HEALTH OBGYN & MIDWIFERY LLC
Entity Type:Organization
Organization Name:ALL ABOUT WOMENS HEALTH OBGYN & MIDWIFERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HUSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-690-3131
Mailing Address - Street 1:1890 SILVER CROSS BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1890 SILVER CROSS BLVD STE 330
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9528
Practice Address - Country:US
Practice Address - Phone:815-717-6082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-12
Last Update Date:2015-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036110113207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036110113OtherLICENSE