Organization
NANCY R G CHURCH MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY R CHURCH M D (OWNER)
(773) 233-6500
Entity
Organization
Contact information
Practice address
10725 S WESTERN AVE, CHICAGO, IL 60643-3135
(773) 233-6500
(773) 233-2369
Mailing address
10725 S WESTERN AVE, CHICAGO, IL 60643-3135
(773) 233-6500
(773) 233-2369
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036085259
IL
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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