| NPI | 1114278009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IQBAL HUSSAIN Chief Financial Officer 773-651-3635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: IL BL9194919) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2024-03-06 |