| NPI | 1487193181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY TAYLOR Excetive Director 312-413-1261 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2019-09-04 |