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Organization

NORTHERN ILLINOIS FERTILITY SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH BAUMGART MD (OWNER)
(815) 758-8621
Entity
Organization

Contact information

Practice address
625 BETHANY RD, SUITE 1, DEKALB, IL 60115-4908
(815) 758-8621
(815) 758-5838
Mailing address
625 BETHANY RD, SUITE 1, DEKALB, IL 60115-4908
(815) 758-8621
(815) 758-5838

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
IL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
IL
367A00000X
Advanced Practice Midwife
IL

Other

Enumeration date
09/14/2005
Last updated
07/21/2022
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