| NPI | 1104905702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA THOMPSON CEO 312-526-2051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2017-03-22 |