Basic Information
| Provider Information | |||||||||
| NPI: | 1699985325 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE WOMENS PRACTICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 737 N MICHIGAN AVE | ||||||||
| Address2: | 950 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606112615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127517515 | ||||||||
| FaxNumber: | 3127511208 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 E HURON ST | ||||||||
| Address2: | 825 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606112999 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127517515 | ||||||||
| FaxNumber: | 3127511208 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MCGINNIS | ||||||||
| AuthorizedOfficialFirstName: | RAQUE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3127517515 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LX0001X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
No ID Information.