OrganizationActive
Innovative Women'S Healthcare, PLLC
NPI 1104535335 · Multi-Specialty Clinic/Center · Maryville, IL
Provider details
- NPI number
- 1104535335
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tamara Young, Owner/Manager(618) 444-5475
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2016 Vadalabene Dr Ste D
Maryville, IL 62062-6901
Phone: (618) 444-5475
Street-level locationGet directions
Mailing address
1087 Il Route 127
Greenville, IL 62246-3041
Registry dates
- Enumerated
- 2022-11-16
- Last updated
- 2022-11-16
- Certified
- 2022-11-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.