| NPI | 1063421899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MOEN Pres 847-825-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2018-08-09 |