is a Primary Care in Chicago, Illinois. practices all healthcare services and medical treatments related to Primary Care. The NPI Number for is 1982814992. The last update date is .
's current location address is 809 N Western Ave, Chicago, Illinois. You can contact this provider via phone number 7732768600 and fax number 7732768601. The mailing address for is 809 N Western Ave, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 809 N Western Ave, Chicago, Illinois |
| Phone Number | 7732768600 |
| Fax Number | 7732768601 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1982814992 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 809 N Western Ave |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606224637 |
| Phone Number | 7732768600 |
| Fax Number | 7732768601 |
Provider's Primary Taxonomy Detail
| Speciality | Primary Care |
|---|---|
| Taxonomy | 261Qp2300X |
|
Definition: Serves as the first point of contact for comprehensive healthcare services. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1632565 | IL | BCBS |
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