Organization Name: | LA GRANGE WOMEN'S CLINIC SC |
NPI Number: | 1740289354 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS J FUREY (PRESIDENT, BOONSLICK MED.GROUP INC) |
Mailing Address: | 5201 Willow Springs Rd Ste 490 La Grange Highlands |
State: | IL US |
Postal Code: | 605256537 |
Phone Number: | 7083524630 |
Fax Number: | 7083528348 |
NPI Enumeration Date: | 07/15/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |