Provider Demographics
NPI:1972798627
Name:WOMENS HEALTHCARE CENTER
Entity type:Organization
Organization Name:WOMENS HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATTERJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-854-0688
Mailing Address - Street 1:2230 HUNTINGTON DR N
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-4419
Mailing Address - Country:US
Mailing Address - Phone:847-854-0688
Mailing Address - Fax:847-854-0696
Practice Address - Street 1:2230 HUNTINGTON DR N
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-4419
Practice Address - Country:US
Practice Address - Phone:847-854-0688
Practice Address - Fax:847-854-0696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090866207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05608706OtherBLUE CROSS BLUE SHIELD PROVIDER NUMBER
574720Medicare PIN