Provider Demographics
NPI:1467897710
Name:BIOHORMONES INC
Entity Type:Organization
Organization Name:BIOHORMONES INC
Other - Org Name:WOMEN'S WELLNESS & REJUVENATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LETA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:APN, CNM
Authorized Official - Phone:224-635-8324
Mailing Address - Street 1:2500 W HIGGINS RD
Mailing Address - Street 2:STE 470
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-7220
Mailing Address - Country:US
Mailing Address - Phone:224-653-8324
Mailing Address - Fax:224-653-8365
Practice Address - Street 1:2500 W HIGGINS RD
Practice Address - Street 2:STE 470
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7220
Practice Address - Country:US
Practice Address - Phone:224-653-8324
Practice Address - Fax:224-653-8365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209005087261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty