Basic Information
| Provider Information | |||||||||
| NPI: | 1023186079 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOMEN'S HEALTHCARE SPECIALISTS, P.C. | ||||||||
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| OtherOrganizationName: | WOMEN'S CARE OF SOUTHERN ILLINOIS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4600 MEMORIAL DR STE 400 | ||||||||
| Address2: | MEDICAL OFFICE CENTER TWO | ||||||||
| City: | BELLEVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622265366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6182342390 | ||||||||
| FaxNumber: | 6182349936 | ||||||||
| Practice Location | |||||||||
| Address1: | 4600 MEMORIAL DR STE 400 | ||||||||
| Address2: | MEDICAL OFFICE CENTER TWO | ||||||||
| City: | BELLEVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622265366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6182342390 | ||||||||
| FaxNumber: | 6182349936 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CHADWICK | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6182342390 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.