| NPI | 1205022506 |
|---|---|
| Doing Business As | MILE SQUARE- IHC THRESHOLDS MOTHERS PROGRAM |
| Entity Type | Organization |
| Authorized Contact | WILLIAM R NICOLAS Executive Director Uic Medical Pla 312-413-0573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2008-08-05 |