Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Illinois Urogynecology, Ltd

Organization Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician · NPI 1063421899

Illinois Urogynecology, Ltd is an Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Park Ridge, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
Specialties on file
2
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1875 Dempster St Ste 665
Park Ridge, IL 60068-1186
Phone: (847) 825-1590
Fax: (847) 825-1604
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician (primary) Taxonomy 207VF0040X (IL)
Gynecology Physician Taxonomy 207VG0400X (IL)

Record details

NPI number1063421899
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Moen — Pres · (847) 825-1590
NPI enumeratedAugust 8, 2006
Last updated in NPPESJune 16, 2026
Certification dateJune 16, 2026
Mailing address1875 Dempster St, Suite 665, Park Ridge, IL 60068-1186

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