| NPI | 1093404576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA CLARKE CEO 773-995-1940 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2024-12-03 |