| NPI | 1225010911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MOLDOVAN Chief Financial Officer 312-491-5034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2017-10-26 |