1. Home
  2. Directory
  3. Illinois
  4. Park Ridge
  5. Obstetrics Gynecology
  6. NPI Profile

ILLINOIS UROGYNECOLOGY, LTD.
NPI 1063421899
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Park Ridge, IL

Active since August 08, 2006CLIA 14D1039338 · Waiver
1875 DEMPSTER ST, SUITE 665, PARK RIDGE, IL 60068(847) 825-1590(847) 825-1604 Get Directions Write a Review

NPPES record last updated: June 16, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Illinois Urogynecology, Ltd. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ILLINOIS UROGYNECOLOGY, LTD. (NPI 1063421899) is a healthcare organization registered as an urogynecology and reconstructive pelvic surgery in Park Ridge, Illinois and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through April 11, 2027 and lists Michael Moen, Pres, as its authorized official.

NPPES Registry Identity

NPI1063421899
Entity TypeOrganization
Primary Taxonomy207VF0040X
Legal Business NameILLINOIS UROGYNECOLOGY, LTD.
Location Address1875 DEMPSTER ST, SUITE 665Park Ridge, IL 60068-1186
Mailing Address1875 Dempster St, Suite 665Park Ridge, IL 60068-1186 · (847) 825-1590 · Fax (847) 825-1604
Phone(847) 825-1590
Fax(847) 825-1604
Organization SubpartNo
Authorized OfficialMichael MoenPres · (847) 825-1590
Enumeration DateAugust 8, 2006
Last NPPES UpdateJune 16, 2026
NPPES CertifiedJune 16, 2026
✔ NPI 1063421899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & Gynecology · Urogynecology and Reconstructive Pelvic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207VF0040X
Definition

A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.

Also ListedObstetrics & Gynecology · GynecologyTaxonomy 207VG0400X
1875 DEMPSTER ST, Park Ridge, IL 60068
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1039338

Illinois Urogynecology Ltd · Park Ridge, IL
Active · expires Apr 11, 2027
CLIA Number14D1039338
Laboratory TypePhysician Office
Certificate Effective DateApril 12, 2025
Certificate Expiration DateApril 11, 2027
Laboratory DirectorMichael D. Moen, MD
Laboratory Phone(847) 825-1590
Laboratory LocationIllinois Urogynecology Ltd1875 Dempster St - Suite 665, Park Ridge, IL 60068
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMY MINER APN-CNP
Nurse Practitioner (Family)
1875 DEMPSTER ST
PARK RIDGE, IL 60068
Cook County (844) 725-5238
DR. MANOJ SHAH MD
Surgery
1875 DEMPSTER ST, SUITE 280
PARK RIDGE, IL 60068
Cook County (847) 318-9071
DR. MICHAEL LAYLAND MD
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
1875 DEMPSTER ST, STE 301
PARK RIDGE, IL 60068
Cook County (847) 685-1000
BRIAN PETER MCCULLOCH M.D.
Obstetrics & Gynecology (Maternal & Fetal Medicine)
1875 DEMPSTER ST, SUITE 325
PARK RIDGE, IL 60068
Cook County (847) 723-8610
DR. DAVID P TOJO MD
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
1875 DEMPSTER ST, STE 301
PARK RIDGE, IL 60068
Cook County (847) 685-1000
ANDREA MAGYAR GADSON MPT
Physical Therapist (Sports)
1875 DEMPSTER ST
PARK RIDGE, IL 60068
Cook County (847) 723-7856
MR. JAN R DELARIMAN O.T.
Occupational Therapist (Hand)
1875 DEMPSTER ST, SUITE G10
PARK RIDGE, IL 60068
Cook County (847) 723-7059
DR. ISABEL GOMEZ MD
Obstetrics & Gynecology
1875 DEMPSTER ST, SUITE 340
PARK RIDGE, IL 60068
Cook County (847) 655-8500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Illinois Urogynecology, Ltd.'s NPI number?

The NPI number for Illinois Urogynecology, Ltd. is 1063421899. It was assigned to this organization in the NPPES registry on August 8, 2006.

Where is Illinois Urogynecology, Ltd. located?

Illinois Urogynecology, Ltd. is located at 1875 Dempster St Suite 665, Park Ridge, IL 60068. The listed phone number is (847) 825-1590.

What is Illinois Urogynecology, Ltd.'s specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Urogynecology and Reconstructive Pelvic Surgery, with taxonomy code 207VF0040X.

Does Illinois Urogynecology, Ltd. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1039338) is associated with this NPI, valid through April 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Illinois Urogynecology, Ltd. was last updated on June 16, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.