Provider Demographics
NPI:1538446141
Name:ADVANCED WOMEN'S HEALTH OF CHICAGO, SC
Entity type:Organization
Organization Name:ADVANCED WOMEN'S HEALTH OF CHICAGO, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUE
Authorized Official - Middle Name:BURCU
Authorized Official - Last Name:ONISPIR-KAFALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-971-5826
Mailing Address - Street 1:3000 N HALSTED ST
Mailing Address - Street 2:SUITE 721
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5188
Mailing Address - Country:US
Mailing Address - Phone:773-281-6333
Mailing Address - Fax:773-472-3845
Practice Address - Street 1:3000 N HALSTED ST
Practice Address - Street 2:SUITE 721
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5188
Practice Address - Country:US
Practice Address - Phone:773-281-6333
Practice Address - Fax:773-472-3845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty