Organization · Type 2 NPI

Cook County

Primary Care Clinic/Center · Chicago, IL

NPI number 1124148366 Active

Practice location

3410 W Van Buren St
Chicago, IL 60624-3358

Call (773) 265-2800 Map

Mailing address

1110 S Oakley Blvd, Room 200
Chicago, IL 60612-4218

Specialties and licenses

TaxonomyCodeLicense
Primary Care Clinic/Center Primary 261QP2300X0005272 (IL)

Primary Care Clinic/Center: Definition to come...

2 other providers at this address

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About NPI 1124148366

Cook County's National Provider Identifier is 1124148366, issued on Mar 30, 2007. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Chicago, IL. The record was last updated on Aug 22, 2020.