Provider Demographics
NPI:1508183583
Name:THE WOMEN INSTITUTE SC
Entity Type:Organization
Organization Name:THE WOMEN INSTITUTE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-382-1224
Mailing Address - Street 1:1629 S PRAIRIE AVE
Mailing Address - Street 2:# 1508
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4403
Mailing Address - Country:US
Mailing Address - Phone:773-382-1224
Mailing Address - Fax:773-362-1085
Practice Address - Street 1:4101 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-2813
Practice Address - Country:US
Practice Address - Phone:773-382-1224
Practice Address - Fax:773-362-1085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036118733207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036118733OtherSTATE LICENSE