Organization · Type 2 NPI
Cook County
Primary Care Clinic/Center · Chicago, IL
NPI number
1689794489
Active
Practice location
5501 W. Fullerton Ave
Chicago, IL 60639
Mailing address
1900 W Polk St Rm 220C
Chicago, IL 60612-3723
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | 0005272 (IL) |
Primary Care Clinic/Center: Definition to come...
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About NPI 1689794489
Cook County's National Provider Identifier is 1689794489, issued on Mar 29, 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 Jan 25, 2022.