Provider Demographics
NPI:1447407846
Name:TOTAL WOMENS HEALTHCARE,LLC
Entity type:Organization
Organization Name:TOTAL WOMENS HEALTHCARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:PRESKILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-362-0100
Mailing Address - Street 1:114 W ROCKLAND RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-2774
Mailing Address - Country:US
Mailing Address - Phone:847-362-0100
Mailing Address - Fax:
Practice Address - Street 1:114 W ROCKLAND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-2774
Practice Address - Country:US
Practice Address - Phone:847-362-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036081833207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04923779OtherBLUE CROSS BLUE SHIELD
IL04923779OtherBLUE CROSS BLUE SHIELD