| NPI | 1770900839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELA NORENA Billing Manager 312-432-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |