| NPI | 1649718594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY TAYLOR Executive Director 312-412-1261 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-10 |