Provider Demographics
NPI:1124327598
Name:WOMEN'S HEALTH CARE SPECIALISTS OF DECATUR, LLC
Entity type:Organization
Organization Name:WOMEN'S HEALTH CARE SPECIALISTS OF DECATUR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:LIEN
Authorized Official - Last Name:BYRKIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-875-5574
Mailing Address - Street 1:1 MEMORIAL DR
Mailing Address - Street 2:PHYSICIANS PLAZA EAST, SUITE 216
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-6303
Mailing Address - Country:US
Mailing Address - Phone:217-875-5574
Mailing Address - Fax:
Practice Address - Street 1:1 MEMORIAL DR
Practice Address - Street 2:PHYSICIANS PLAZA EAST, SUITE 216
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-6303
Practice Address - Country:US
Practice Address - Phone:217-875-5574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty