| NPI | 1033838214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA DENISE SMITH Patient Revenue Manager 312-337-1073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 174200000X Meals |
| 251J00000X Nursing Care | |
| 261Q00000X Clinic/Center | |
| 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QR1300X Clinic/Center Rural Health | |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2022-08-23 |