| NPI | 1710096482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTHER CORPUZ CEO 312-829-6304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IL 1138738) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2023-08-31 |