Provider Demographics
NPI:1417210030
Name:ALPHA FERTILITY INC.
Entity Type:Organization
Organization Name:ALPHA FERTILITY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HISHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GREISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD, HCLD, TBS
Authorized Official - Phone:630-427-0300
Mailing Address - Street 1:8635 LEMONT RD
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-4805
Mailing Address - Country:US
Mailing Address - Phone:630-427-0309
Mailing Address - Fax:630-427-0302
Practice Address - Street 1:8635 LEMONT RD
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-4805
Practice Address - Country:US
Practice Address - Phone:630-427-0309
Practice Address - Fax:630-427-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD141357261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical