Organization · Type 2 NPI

Advocate Illinois Masonic

Student in an Organized Health Care Education/Training Program · Chicago, IL

NPI number 1376700732 Active

Practice location

836 W Wellington Ave, Family Practice
Chicago, IL 60657-5147

Call (773) 296-8250 Map

Mailing address

3430 N Elaine Pl, Apt 4
Chicago, IL 60657-2483

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1376700732

Advocate Illinois Masonic's National Provider Identifier is 1376700732, issued on May 21, 2008. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Chicago, IL. The record was last updated on May 21, 2008.