Organization · Type 2 NPI

Cook County

Multi-Specialty Clinic/Center · Chicago, IL

NPI number 1245350040 Active

Practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

1900 W Polk St Ste 220C
Chicago, IL 60612-3723

Specialties and licenses

TaxonomyCodeLicense
Multi-Specialty Clinic/Center Primary 261QM1300X0005272 (IL)

Multi-Specialty Clinic/Center: Definition to come...

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About NPI 1245350040

Cook County's National Provider Identifier is 1245350040, issued on Mar 29, 2007. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Chicago, IL. The record was last updated on Jun 6, 2022.