| NPI | 1750757449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE OGBUAGU Manager, Revenue Cycle 773-298-2056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IL 209012746) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2022-02-09 |