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1184672966
PORTAGE PARK MEDICAL GROUP
CHICAGO, IL
NPI
1184672966
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Entity Type
Organization
Authorized Contact
RICHARD ANSFIELD
Director
773-286-8822
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2006-05-04
Last Update Date
2020-08-22
Business Address
PORTAGE PARK MEDICAL GROUP
3401 N CENTRAL AVE
CHICAGO, IL 60634-4426
Phone number: 773-286-8822
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Mailing Address
PORTAGE PARK MEDICAL GROUP
3401 N CENTRAL AVE
CHICAGO, IL 60634-4426
Phone number: 773-286-8822
Copy
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