Organization
COMPREHENSIVE CENTER FOR WOMENS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTINA S COCKERILL CPA (PRACTICE ADMINISTRATOR)
(773) 435-1150
Entity
Organization
Contact information
Practice address
1 E DELAWARE PL, 501, CHICAGO, IL 60611-1449
(773) 435-1150
(773) 435-1330
Mailing address
1 E DELAWARE PL, 501, CHICAGO, IL 60611-1449
(773) 435-1150
(773) 435-1330
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1630135
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/07/2007
Last updated
11/04/2008
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