| NPI | 1598879819 |
|---|---|
| Doing Business As | MILE SQUARE-IHC THRESHOLDS SOUTH |
| Entity Type | Organization |
| Authorized Contact | WILLIAM R. NICHOLAS Executive Director Uic Medical Plan 312-413-0573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-08-01 |