Provider Demographics
NPI:1932110962
Name:MOTHER & CHILD HEALTHCARE, PC
Entity Type:Organization
Organization Name:MOTHER & CHILD HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERMAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CALONJE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-755-1300
Mailing Address - Street 1:1555 BARRINGTON RD
Mailing Address - Street 2:SUITE 515
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1019
Mailing Address - Country:US
Mailing Address - Phone:847-755-1300
Mailing Address - Fax:847-755-1400
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:SUITE 515
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1019
Practice Address - Country:US
Practice Address - Phone:847-755-1300
Practice Address - Fax:847-755-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.111247207V00000X
IL036111247207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111247Medicaid
IL1635377OtherBLUE CROSS BLUE SHIELD
ILD89916Medicare UPIN
IL211919Medicare PIN