| NPI | 1639983521 |
|---|---|
| Doing Business As | CCRH - GATOR LANE HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | TARIQ A MUHAMMAD CEO 312-523-5180 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2025-02-03 |
| Last Update Date | 2025-02-03 |