| NPI | 1306486022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY TAYLOR Executive Director 312-413-1261 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-01-10 |