Provider Demographics
NPI:1841225844
Name:WOMEN FOR WOMEN OB-GYN SC
Entity Type:Organization
Organization Name:WOMEN FOR WOMEN OB-GYN SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KORNELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KROL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-775-7883
Mailing Address - Street 1:6438 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-2935
Mailing Address - Country:US
Mailing Address - Phone:773-775-7883
Mailing Address - Fax:773-775-7885
Practice Address - Street 1:6438 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-2935
Practice Address - Country:US
Practice Address - Phone:773-775-7883
Practice Address - Fax:773-775-7885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214511Medicare ID - Type UnspecifiedMEDICARE