| NPI | 1700969250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REUBEN PETTIFORD CEO 773-379-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |