Provider Demographics
NPI:1497942908
Name:WOMEN OB GYN ASSOCIATES PC
Entity Type:Organization
Organization Name:WOMEN OB GYN ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-719-9229
Mailing Address - Street 1:4121 FAIRVIEW AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2267
Mailing Address - Country:US
Mailing Address - Phone:630-719-9229
Mailing Address - Fax:630-719-9452
Practice Address - Street 1:4121 FAIRVIEW AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2267
Practice Address - Country:US
Practice Address - Phone:630-719-9229
Practice Address - Fax:630-719-9452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X, 207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL931690Medicare PIN