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Organization

OLD ORCHARD OBSTETRICS&GYNECOLOGY, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALICE CHEN M. D. (PRESIDENT)
(847) 568-1870
Entity
Organization

Contact information

Practice address
4711 GOLF RD, SUITE 808, SKOKIE, IL 60076-1224
(847) 568-1870
(847) 568-1875
Mailing address
4711 GOLF RD, SUITE 808, SKOKIE, IL 60076-1224
(847) 568-1870
(847) 568-1875

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
042616899
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036086420
IL
01
14D0937849
CLIA
IL
Enumeration date
11/18/2008
Last updated
11/20/2008
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