Provider Demographics
NPI:1255453494
Name:CHAMS WOMEN'S HEALTH CARE, SC
Entity type:Organization
Organization Name:CHAMS WOMEN'S HEALTH CARE, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-283-3404
Mailing Address - Street 1:4600 W PETERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5833
Mailing Address - Country:US
Mailing Address - Phone:773-283-3404
Mailing Address - Fax:
Practice Address - Street 1:4200 W PETERSON AVE STE 101
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-6052
Practice Address - Country:US
Practice Address - Phone:773-283-3404
Practice Address - Fax:773-283-3548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherTIN