Provider Demographics
NPI:1427587781
Name:CHICAGO MATERNAL FETAL MEDICINE, SC
Entity Type:Organization
Organization Name:CHICAGO MATERNAL FETAL MEDICINE, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAWAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HATOUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-348-8032
Mailing Address - Street 1:2507 N HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-9267
Mailing Address - Country:US
Mailing Address - Phone:773-348-8032
Mailing Address - Fax:773-348-8042
Practice Address - Street 1:2507 NORTH HALSTED STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614
Practice Address - Country:US
Practice Address - Phone:773-348-8032
Practice Address - Fax:773-348-8042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty