| NPI | 1205374964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MOLDOVAN CFO/COO 312-491-5034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-10-26 |