Provider Demographics
NPI:1609150234
Name:WOMENS HEALTH INSTITUTE OF ILLINOIS LTD
Entity Type:Organization
Organization Name:WOMENS HEALTH INSTITUTE OF ILLINOIS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-499-9800
Mailing Address - Street 1:5851 W 95TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2362
Mailing Address - Country:US
Mailing Address - Phone:708-499-9800
Mailing Address - Fax:708-499-6203
Practice Address - Street 1:5851 W 95TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2362
Practice Address - Country:US
Practice Address - Phone:708-499-9800
Practice Address - Fax:708-499-6203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-30
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL6503Medicare PIN
ILIL6502Medicare PIN