| NPI | 1851695514 |
|---|---|
| Doing Business As | CHICAGO AVENUE CLINIC |
| Entity Type | Organization |
| Authorized Contact | SAHRA NOOR CEO 612-332-4973 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2016-06-07 |