| NPI | 1306070784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTHER CORPUZ CEO 312-829-6304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IL 1138738) |
| Additional Taxonomies | 261Q00000X (Licence: IL 1138738) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2014-08-19 |