| NPI | 1083860845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTHER CORPUZ CEO 312-829-6304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| 261QD0000X Clinic/Center, Dental | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2014-08-19 |