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Organization
FOR WOMEN, LTD
Active
Organization
FOR WOMEN, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAVIER ENRIQUE FAJARDO M.D. (PRESIDENT)
(312) 919-5023
Entity
Organization
Contact information
Practice address
680 N LAKE SHORE DR, SUITE 1202, CHICAGO, IL 60611-4546
(312) 919-5023
Mailing address
901 W MADISON ST UNIT 419, CHICAGO, IL 60607-3370
(312) 919-5023
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
04/25/2010
Last updated
06/30/2010
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