Provider Demographics
NPI:1699382531
Name:CONTEMPORARY OB/GYN CHICAGO, PLLC
Entity Type:Organization
Organization Name:CONTEMPORARY OB/GYN CHICAGO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-636-5341
Mailing Address - Street 1:8140 S SPAULDING AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-2613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2007 S STATE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2173
Practice Address - Country:US
Practice Address - Phone:773-340-2546
Practice Address - Fax:773-340-2547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty