Provider Demographics
NPI:1477727550
Name:ALL WOMEN'S MEDICAL CENTER
Entity Type:Organization
Organization Name:ALL WOMEN'S MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEHRER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-478-0700
Mailing Address - Street 1:3140 W IRVING PRK. RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618
Mailing Address - Country:US
Mailing Address - Phone:773-478-0700
Mailing Address - Fax:
Practice Address - Street 1:3140 W IRVING PRK. RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618
Practice Address - Country:US
Practice Address - Phone:773-478-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036046486Medicaid
IL036046486Medicaid
IL499260Medicare PIN