Organization
AMERICAN WOMENS MEDICAL GROUP
Active
Other names
Western Diversey Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
RENLIN XIA M.D. (OWNER)
(773) 235-8000
Entity
Organization
Contact information
Practice address
2744 N WESTERN AVE, CHICAGO, IL 60647
(773) 772-7726
(773) 772-3696
Mailing address
2744 N WESTERN AVE, CHICAGO, IL 60647
(773) 772-7726
(773) 772-3696
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7000037
IL
Other
Enumeration date
01/16/2007
Last updated
06/14/2019
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