Provider Demographics
NPI:1881789279
Name:VALLEY WOMEN'S HEALTH S.C
Entity type:Organization
Organization Name:VALLEY WOMEN'S HEALTH S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCES
Authorized Official - Prefix:DR
Authorized Official - First Name:SHRISH
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOMUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-375-0101
Mailing Address - Street 1:2541 FAWNLAKE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564
Mailing Address - Country:US
Mailing Address - Phone:630-375-0101
Mailing Address - Fax:630-375-1311
Practice Address - Street 1:2121 RIDGE AVE,SUITE 103
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504
Practice Address - Country:US
Practice Address - Phone:630-375-0101
Practice Address - Fax:630-375-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090195174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK23630Medicare PIN
ILG07495Medicare UPIN