| NPI | 1326031998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JACKSON CFO 773-379-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2022-07-21 |