| NPI | 1174853410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGIL TOLBERT Executive Director 773-233-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2022-02-09 |