| NPI | 1285882639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASMAMAW KASSIE BEYENE Manager 773-227-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: IL 36.119662) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-08-28 |