Provider Demographics
NPI:1275662835
Name:NORTHWESTERN WOMENS HEALTH ASSOCIATES SC
Entity Type:Organization
Organization Name:NORTHWESTERN WOMENS HEALTH ASSOCIATES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRIEDELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-440-9400
Mailing Address - Street 1:680 N LAKESHORE DRIVE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4546
Mailing Address - Country:US
Mailing Address - Phone:312-440-9400
Mailing Address - Fax:312-440-0423
Practice Address - Street 1:680 N LAKESHORE DRIVE
Practice Address - Street 2:SUITE 1200
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4546
Practice Address - Country:US
Practice Address - Phone:312-440-9400
Practice Address - Fax:312-440-0423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042007530207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty