Organization Active NPI

Advanced Healthcare for Women,LTD.

  • Obstetrics & Gynecology Physician
  • La Grange Highlands, IL
National Provider Identifier
1508060146
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ADVANCED HEALTHCARE FOR WOMEN,LTD.
Practice address
5201 Willow Springs Rd Ste 120
La Grange Highlands, IL 60525-6540
Phone
(708) 579-0974
Fax
(708) 579-1402
NPI assigned
Jun 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Scott M. Multack, D.O.
Title
Physician
Phone
(708) 579-0974

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X IL Primary

Addresses

Primary practice location

5201 Willow Springs Rd Ste 120
La Grange Highlands, IL 60525-6540

Mailing address

5201 Willow Springs Rd Ste 120
La Grange Highlands, IL 60525-6540
Phone (708) 579-0974

Other identifiers 1

IdentifierTypeStateIssuer
02201639OtherILBCBS

National Provider Directory

National Provider Directory

Locations

777 Oakmont Ln
Ste 1600
Westmont, IL 60559

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508060146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD STE 120",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256540",
            "telephone_number": "708-579-0974",
            "fax_number": "708-579-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD STE 120",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256540",
            "telephone_number": "708-579-0974",
            "fax_number": "708-579-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTHCARE FOR WOMEN,LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MULTACK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "708-579-0974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02201639",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange Highlands, 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.

Verify at the official NPI Registry.