Organization
PROGRESSIVE HEALTH CARE FOR WOMEN, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
URSULA L THATCH M.D (PRESIDENT)
(618) 288-0060
Entity
Organization
Contact information
Practice address
6810 S.R. 162, STE 100, MARYVILLE, IL 62062
(618) 288-0060
(618) 288-0062
Mailing address
6810 S.R. 162, STE 100, MARYVILLE, IL 62062
(618) 288-0060
(618) 288-0062
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
36980
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060-10076
BCBS
IL
Enumeration date
04/13/2007
Last updated
04/20/2008
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