Active NPI
Lifecircle Womens Health SC
- Obstetrics & Gynecology Physician
- Palos Heights, IL
National Provider Identifier
1104049782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- LIFECIRCLE WOMENS HEALTH SC
- Practice address
- 7800 W College Drive
Palos Heights, IL 60463-1007 - Phone
- (708) 361-2400
- Fax
- (708) 361-1592
- NPI assigned
- Apr 11, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kimberly Anne Mullin, MD
- Title
- President
- Phone
- (708) 301-6751
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
7800 W College Drive
Palos Heights, IL 60463-1007
Mailing address
7800 W College Drive
Palos Heights, IL 60463-1007
Phone (708) 361-2400
National Provider Directory
National Provider DirectoryLocations
7800 W College Dr
Palos Heights, IL 60463
Phone (708) 361-2400
7800 W College Dr
Ste 2SW
Palos Heights, IL 60463
Phone (708) 361-2400
7800 W College Dr
Ste 2
Palos Heights, IL 60463
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1104049782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7800 W COLLEGE DRIVE",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631007",
"telephone_number": "708-361-2400",
"fax_number": "708-361-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7800 W COLLEGE DRIVE",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631007",
"telephone_number": "708-361-2400",
"fax_number": "708-361-1592"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFECIRCLE WOMENS HEALTH SC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-11",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MULLIN",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_middle_name": "ANNE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "708-301-6751",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palos Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.