Provider Demographics
NPI:1780017426
Name:CONTEMPORARY OBSTETRICS & GYNECOLOGY WOMENS CARE CENTER LLC
Entity Type:Organization
Organization Name:CONTEMPORARY OBSTETRICS & GYNECOLOGY WOMENS CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MAY
Authorized Official - Middle Name:
Authorized Official - Last Name:YAZEJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-696-5420
Mailing Address - Street 1:4322 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6867
Mailing Address - Country:US
Mailing Address - Phone:309-517-6222
Mailing Address - Fax:309-517-6227
Practice Address - Street 1:4322 7TH ST
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6867
Practice Address - Country:US
Practice Address - Phone:309-517-6222
Practice Address - Fax:309-517-6227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-16
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036116849261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty