Provider Demographics
NPI:1962674515
Name:FOCUS ON WOMENS HEALTH
Entity Type:Organization
Organization Name:FOCUS ON WOMENS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:KOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-518-1300
Mailing Address - Street 1:1875 DEMPSTER ST
Mailing Address - Street 2:SUITE 635
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1186
Mailing Address - Country:US
Mailing Address - Phone:847-518-1300
Mailing Address - Fax:847-518-1303
Practice Address - Street 1:1875 DEMPSTER ST
Practice Address - Street 2:SUITE 635
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1186
Practice Address - Country:US
Practice Address - Phone:847-518-1300
Practice Address - Fax:847-518-1303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036071750174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036071750Medicaid
IL246240Medicare PIN
ILC51012Medicare UPIN
IL036071750Medicaid