Provider Demographics
NPI:1851595995
Name:NORTHWEST PROFESSIONAL OBSTETRICS & GYNECOLOGY LTD
Entity Type:Organization
Organization Name:NORTHWEST PROFESSIONAL OBSTETRICS & GYNECOLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-577-2229
Mailing Address - Street 1:121 S WILKE RD
Mailing Address - Street 2:SUITE 515
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1533
Mailing Address - Country:US
Mailing Address - Phone:847-577-2229
Mailing Address - Fax:847-577-6444
Practice Address - Street 1:121 S WILKE RD
Practice Address - Street 2:SUITE 515
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1533
Practice Address - Country:US
Practice Address - Phone:847-577-2229
Practice Address - Fax:847-577-6444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042.005547174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL964370Medicare PIN