| NPI | 1629696679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTEN TIBBS Physician 773-234-9662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-07-07 |