| NPI | 1750619680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANARA LEAKE Revenue Cycle Manager 773-233-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2022-12-29 |