Provider Demographics
NPI:1396949525
Name:A WOMANS PLACE INC
Entity type:Organization
Organization Name:A WOMANS PLACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-548-9346
Mailing Address - Street 1:619 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6772
Mailing Address - Country:US
Mailing Address - Phone:630-548-9346
Mailing Address - Fax:630-548-9376
Practice Address - Street 1:619 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6772
Practice Address - Country:US
Practice Address - Phone:630-548-9346
Practice Address - Fax:630-548-9376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000222495OtherBLUE CROSS BLUE SHHEILD
IN2003875540AMedicaid
IN4358730001Medicare PIN
IN2003875540AMedicaid