NPI | 1861013583 |
---|---|
Entity Type | Organization |
Authorized Contact | LAKISA DAVIS Com 773-389-1899 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 207Q00000X Family Medicine |
363A00000X Physician Assistant | |
363LP2300X Nurse Practitioner, Primary Care | |
374J00000X Doula | |
Enumeration Date | 2020-05-05 |
Last Update Date | 2022-06-08 |