Organization
MIDWEST PERINATAL CONSULTANTS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA MANOGURA MD (OWNER/PHYSICIAN)
(224) 783-8975
Entity
Organization
Contact information
Practice address
1425 N RANDALL RD, SHERMAN HOSP, SUITE 1-2150, ELGIN, IL 60123-2300
(224) 783-8975
Mailing address
PO BOX 743, ELGI, IL 60121
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124176987
INDIVIDUAL NPI
—
Enumeration date
12/21/2011
Last updated
12/21/2011
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