Organization
CHICAGO WOMEN'S HEALTH GROUP AT NORTHWESTERN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MOORE (OFFICE MANAGER)
(312) 943-0282
Entity
Organization
Contact information
Practice address
333 E SUPERIOR ST, SUITE 444, CHICAGO, IL 60611-2654
(312) 943-0282
(312) 943-0284
Mailing address
333 E SUPERIOR ST, SUITE 444, CHICAGO, IL 60611-2654
(312) 943-0282
(312) 943-0284
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
042006984
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016-20273
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/25/2006
Last updated
08/22/2020
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