Provider Demographics
NPI:1447200654
Name:MIDWEST CENTER FOR WOMEN'S HEALTH CARE, LTD.
Entity Type:Organization
Organization Name:MIDWEST CENTER FOR WOMEN'S HEALTH CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PAYER ENROLLMENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-486-8439
Mailing Address - Street 1:2801 LAKESIDE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1271
Mailing Address - Country:US
Mailing Address - Phone:847-562-1410
Mailing Address - Fax:847-562-0830
Practice Address - Street 1:2801 LAKESIDE DR STE 209
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1271
Practice Address - Country:US
Practice Address - Phone:847-562-1410
Practice Address - Fax:847-562-0830
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDWEST CENTER FOR WOMEN'S HEALTH CARE, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-10
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL202301Medicare PIN
IL202300Medicare PIN