CONTEMPORARY OBSTETRICS & GYNECOLOGY WOMENS CARE CENTER LLC - NPI NUMBER 1780017426

Summary

Provider Name: CONTEMPORARY OBSTETRICS & GYNECOLOGY WOMENS CARE CENTER LLC

NPI Number: 1780017426

Clasification: Clinic/Center (261QM2500X)

Specialization: Medical Specialty

Address:
4322 7TH ST
MOLINE, IL
ZIP 61265

Phone Number: (309) 517-6222



Detailed Information

CONTEMPORARY OBSTETRICS & GYNECOLOGY WOMENS CARE CENTER LLC is a medical specialty clinic/center in Moline, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). The assigned NPI number for this provider is 1780017426 and is registered as an organization entity type.

The provider's business address is:

4322 7TH ST
MOLINE, IL
ZIP 61265-867
Phone: (309) 517-6222
Fax: (309) 517-6227

The provider's authorized official is May Yazeji .
The authorized official title is Physician and has the following contact phone number (309) 696-5420.

The enumeration date for this NPI number is 8/16/2013 and was last updated on 11/11/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QM2500X Clinic/Center Medical Specialty 036116849 IL Yes

NPI Record

No. Field Name Field Value
1 NPI 1780017426
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name CONTEMPORARY OBSTETRICS & GYNECOLOGY WOMENS CARE CENTER LLC
5 Provider First Line Business Practice Location Address 4322 7TH ST
6 Provider Business Practice Location Address City Name MOLINE
7 Provider Business Practice Location Address State Name IL
8 Provider Business Practice Location Address Postal Code 612656867
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 3095176222
11 Provider Business Practice Location Address Fax Number 3095176227
12 Provider Enumeration Date 8/16/2013
13 Last Update Date 11/11/2013
14 Authorized Official Last Name YAZEJI
15 Authorized Official First Name MAY
16 Authorized Official Title or Position PHYSICIAN
17 Authorized Official Telephone Number 3096965420
18 Healthcare Provider Taxonomy Code 1 261QM2500X
19 Provider License Number 1 036116849
20 Provider License Number State Code 1 IL
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Organization Subpart N
23 Authorized Official Name Prefix Text DR.
24 Authorized Official Credential Text MD

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This page was last updated on: 3/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.