Provider Demographics
NPI:1265537690
Name:TOUSSAINT OBSTETRICS AND GYNECOLOGY, P.C.
Entity type:Organization
Organization Name:TOUSSAINT OBSTETRICS AND GYNECOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:N
Authorized Official - Last Name:TOUSSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:815-941-0441
Mailing Address - Street 1:237 W WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1334
Mailing Address - Country:US
Mailing Address - Phone:815-941-0441
Mailing Address - Fax:815-941-0472
Practice Address - Street 1:237 W WAVERLY ST
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-1334
Practice Address - Country:US
Practice Address - Phone:815-941-0441
Practice Address - Fax:815-941-0472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL524140Medicare ID - Type UnspecifiedMEDICARE NUMBER