| NPI | 1912192253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA THOMPSON CEO 773-257-6770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2008-06-16 |