Provider Demographics
NPI:1790020006
Name:MIDWEST OB/GYN & MIDWIFERY
Entity Type:Organization
Organization Name:MIDWEST OB/GYN & MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB/GYN
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-357-1144
Mailing Address - Street 1:800 BIESTERFIELD RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3361
Mailing Address - Country:US
Mailing Address - Phone:847-357-1144
Mailing Address - Fax:847-357-9449
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:SUITE 306
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3361
Practice Address - Country:US
Practice Address - Phone:847-357-1144
Practice Address - Fax:847-357-9449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty