Provider Demographics
NPI:1700292455
Name:CENTER FOR GYNECOLOGY AND COSMETICS, LTD
Entity Type:Organization
Organization Name:CENTER FOR GYNECOLOGY AND COSMETICS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMEENA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-574-3434
Mailing Address - Street 1:820 W JACKSON BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3026
Mailing Address - Country:US
Mailing Address - Phone:312-574-3434
Mailing Address - Fax:312-724-7647
Practice Address - Street 1:820 W JACKSON BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3026
Practice Address - Country:US
Practice Address - Phone:312-574-3434
Practice Address - Fax:312-724-7647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-122006207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty