MAMANATANDATHERNIZAMPC.

CHICAGO, IL
NPI1104134915
Entity TypeOrganization
Authorized ContactMAIMANAT NIZAM
Physician
630-654-1021
Organization Subpart ?No
Primary Taxonomy261QC1500X Clinic/Center, Community Health
(Licence: IL  036-06-9635)
Enumeration Date2010-09-15
Last Update Date2010-09-15
Business Address
MAMANATANDATHERNIZAMPC.
2001 W.69THST.
CHICAGO, IL 60636
Phone number: 773-778-2355
Mailing Address
MAMANATANDATHERNIZAMPC.
401 TAMERTON PKWY
BURR RIDGE, IL 60527-6347
Phone number: 630-654-1021