Provider Demographics
NPI:1295763886
Name:WOMEN'S DOC OF ELGIN, S. C.
Entity type:Organization
Organization Name:WOMEN'S DOC OF ELGIN, S. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:B
Authorized Official - Last Name:MERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-839-8800
Mailing Address - Street 1:PO BOX 95748
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-0748
Mailing Address - Country:US
Mailing Address - Phone:847-839-8800
Mailing Address - Fax:847-839-8808
Practice Address - Street 1:87 N AIRLITE ST
Practice Address - Street 2:SUITE G14
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4988
Practice Address - Country:US
Practice Address - Phone:847-289-6020
Practice Address - Fax:847-289-6029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208000000X, 207V00000X
IL036116215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1295763886OtherNPI NUMBER
IL2232882OtherBCBS
IL=========OtherTAX ID
IL213431Medicare PIN
IL=========OtherTAX ID