Organization
CHICAGO INFERTILITY ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KETAN NARANDAS JOBANPUTRA M.D,F.A.C.O.G (PRESIDENT, MEDICAL DIRECTOR)
(630) 540-9317
Entity
Organization
Contact information
Practice address
1515 E LAKE ST STE 208, HANOVER PARK, IL 60133-7152
(630) 540-9317
(630) 540-2262
Mailing address
PO BOX 5310, VILLA PARK, IL 60181-5301
(630) 540-9317
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
036102289
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102289
—
IL
Enumeration date
06/04/2007
Last updated
06/12/2008
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