Provider Demographics
NPI:1902927288
Name:PERSONAL WOMEN'S HEALTH CARE, S.C.
Entity Type:Organization
Organization Name:PERSONAL WOMEN'S HEALTH CARE, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OKSANA
Authorized Official - Middle Name:T
Authorized Official - Last Name:BUKACZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-981-8866
Mailing Address - Street 1:800 BIESTERFIELD ROAD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3372
Mailing Address - Country:US
Mailing Address - Phone:847-981-8866
Mailing Address - Fax:
Practice Address - Street 1:800 BIESTERFIELD ROAD
Practice Address - Street 2:SUITE 106
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3372
Practice Address - Country:US
Practice Address - Phone:847-981-8866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL784961Medicare PIN