Provider Demographics
NPI:1770513459
Name:NORTHWEST OBSTETRICS & GYNECOLOGICAL ASSOCIATES, LTD
Entity type:Organization
Organization Name:NORTHWEST OBSTETRICS & GYNECOLOGICAL ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCARIMBOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-825-8108
Mailing Address - Street 1:2 W TALCOTT RD
Mailing Address - Street 2:SUITE 16
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5556
Mailing Address - Country:US
Mailing Address - Phone:847-825-8108
Mailing Address - Fax:847-825-1774
Practice Address - Street 1:2 W TALCOTT RD
Practice Address - Street 2:SUITE 16
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5556
Practice Address - Country:US
Practice Address - Phone:847-825-8108
Practice Address - Fax:847-825-0682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherTAX ID NUMBER